Ruptured pulmonary artery aneurysm mimicking pulmonary embolism

Case Report: Surgical management of idiopathic pulmonary aneurysms and review surgical approaches

Idiopathic pulmonary aneurysm is a clinically rare condition characterized by an unknown etiology and episodic occurrence. Despite its rarity, idiopathic pulmonary artery aneurysm poses potential risks to patients. Currently, there is a lack of established clinical guidelines and consensus regarding its management, leading to ongoing controversies in treatment strategies. Particularly, the optimal approach for addressing the main pulmonary artery, its branches, and the pulmonary artery valve remains uncertain. A 57-year-old female patient presented with chest pain and tightness, leading to the diagnosis of idiopathic pulmonary artery aneurysm after excluding other potential causes. Subsequently, she underwent surgical treatment. However, during the surgery, the pulmonary artery wall was found to be extremely weak, prompting us to employ a surgical approach involving the utilization of autologous vessel wrapping with artificial grafts. By summarizing almost all surgical treatment strategies reported in recent years, including the management of pulmonary artery vessels and the pulmonary valve, we have developed a treatment flow chart. This flowchart serves as a valuable guide for the management of future cases presenting similar challenges, offering clinicians valuable insights and evidence-based recommendations.

Pulmonary artery aneurysm: a review

Pulmonary artery aneurysm is a rare but important entity in the spectrum of pulmonary vascular diseases. The etiologies can be varied and patients can present with non-specific symptoms with the diagnosis being incidental. There is limited consensus regarding the diagnostic criteria and follow-up imaging for patients diagnosed with this entity. Further the management strategies can be variable depending upon underlying disease, etiology, center dependent expertise, and resources available. We review the etiologies, epidemiology, classification, clinical manifestations, and imaging features of pulmonary artery aneurysm. We also review the current management strategies and suggest an algorithmic approach to these patients.

Surgical Management of a Pulmonary Arterial Aneurysm via Video-Assisted Thoracoscopic Resection

Pulmonary arterial aneurysm is a rare condition involving a focal dilation of the pulmonary artery and all three layers of the vessel wall. Few reports have described managing this anomaly using video-assisted thoracoscopic surgery. We report a 60-year-old woman with a pulmonary artery aneurysm in the truncus superior of the right pulmonary artery. The patient underwent a two-port video-assisted thoracoscopic surgery with a right upper lobectomy. The postoperative course was uneventful. She maintained a good prognosis for 4 months after surgery, and we continue to take great care throughout her follow-up.