Outcome of Surgical Repair of Pulmonary Artery Aneurysms: A Single-Center Experience With 38 Patients

Janani S. Reisenauer, Sameh M. Said, Hartzell V Schaff, Heidi M. Connolly, Joseph Maleszewski, Joseph A. Dearani

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Pulmonary artery (PA) aneurysms are rare and have been reported only in case reports or small series. We reviewed our experience with surgical repair of PA aneurysms. Methods: We reviewed all patients with a true PA aneurysm undergoing cardiac operations between 1995 and 2015. We excluded aneurysms and pseudoaneurysms related to right ventricular outflow tract patches or previous conduits. Results: There were 38 patients (24 women [63%]; mean age, 46 ± 15 years), and 14 patients (37%) were asymptomatic. The main PA was involved 35 patients (92%). The mean aneurysm diameter was 5.8 ± 1.8 cm. The most common associated pathology was pulmonary valve stenosis/regurgitation in 23 patients (64%). High-pressure (right ventricular systolic pressure >35 mm Hg) aneurysms were present in 23 patients. Operative strategies included reduction arterioplasty in 30 patients (79%) and resection with graft interposition in 8 (21%). The average length of stay was 6.0 ± 2.2 days. There were no early deaths. Late deaths occurred in 3 patients (8%) and were noncardiac related. Late reoperations occurred in 8% and were not related to the PA aneurysm. All high-pressure aneurysms and those larger than 8 cm demonstrated advanced medial necrosis on pathologic examination of the specimens. Conclusions: PA aneurysms are a real entity, and surgical repair can be done with low morbidity and mortality. Aneurysmorrhaphy or aneurysmectomy can be performed, depending on the anatomic location. Regardless of the size of the PA, we recommend intervention on high-pressure aneurysms due to the occurrence of advanced medial necrosis.

Original languageEnglish (US)
JournalAnnals of Thoracic Surgery
DOIs
StateAccepted/In press - 2017

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Pulmonary Artery
Aneurysm
Pressure
Necrosis
Heart Aneurysm
Pulmonary Valve Insufficiency
Pulmonary Valve Stenosis
False Aneurysm
Ventricular Pressure
Reoperation
Length of Stay
Pathology
Blood Pressure
Morbidity
Transplants
Mortality

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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Outcome of Surgical Repair of Pulmonary Artery Aneurysms : A Single-Center Experience With 38 Patients. / Reisenauer, Janani S.; Said, Sameh M.; Schaff, Hartzell V; Connolly, Heidi M.; Maleszewski, Joseph; Dearani, Joseph A.

In: Annals of Thoracic Surgery, 2017.

Research output: Contribution to journalArticle

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abstract = "Background: Pulmonary artery (PA) aneurysms are rare and have been reported only in case reports or small series. We reviewed our experience with surgical repair of PA aneurysms. Methods: We reviewed all patients with a true PA aneurysm undergoing cardiac operations between 1995 and 2015. We excluded aneurysms and pseudoaneurysms related to right ventricular outflow tract patches or previous conduits. Results: There were 38 patients (24 women [63{\%}]; mean age, 46 ± 15 years), and 14 patients (37{\%}) were asymptomatic. The main PA was involved 35 patients (92{\%}). The mean aneurysm diameter was 5.8 ± 1.8 cm. The most common associated pathology was pulmonary valve stenosis/regurgitation in 23 patients (64{\%}). High-pressure (right ventricular systolic pressure >35 mm Hg) aneurysms were present in 23 patients. Operative strategies included reduction arterioplasty in 30 patients (79{\%}) and resection with graft interposition in 8 (21{\%}). The average length of stay was 6.0 ± 2.2 days. There were no early deaths. Late deaths occurred in 3 patients (8{\%}) and were noncardiac related. Late reoperations occurred in 8{\%} and were not related to the PA aneurysm. All high-pressure aneurysms and those larger than 8 cm demonstrated advanced medial necrosis on pathologic examination of the specimens. Conclusions: PA aneurysms are a real entity, and surgical repair can be done with low morbidity and mortality. Aneurysmorrhaphy or aneurysmectomy can be performed, depending on the anatomic location. Regardless of the size of the PA, we recommend intervention on high-pressure aneurysms due to the occurrence of advanced medial necrosis.",
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N2 - Background: Pulmonary artery (PA) aneurysms are rare and have been reported only in case reports or small series. We reviewed our experience with surgical repair of PA aneurysms. Methods: We reviewed all patients with a true PA aneurysm undergoing cardiac operations between 1995 and 2015. We excluded aneurysms and pseudoaneurysms related to right ventricular outflow tract patches or previous conduits. Results: There were 38 patients (24 women [63%]; mean age, 46 ± 15 years), and 14 patients (37%) were asymptomatic. The main PA was involved 35 patients (92%). The mean aneurysm diameter was 5.8 ± 1.8 cm. The most common associated pathology was pulmonary valve stenosis/regurgitation in 23 patients (64%). High-pressure (right ventricular systolic pressure >35 mm Hg) aneurysms were present in 23 patients. Operative strategies included reduction arterioplasty in 30 patients (79%) and resection with graft interposition in 8 (21%). The average length of stay was 6.0 ± 2.2 days. There were no early deaths. Late deaths occurred in 3 patients (8%) and were noncardiac related. Late reoperations occurred in 8% and were not related to the PA aneurysm. All high-pressure aneurysms and those larger than 8 cm demonstrated advanced medial necrosis on pathologic examination of the specimens. Conclusions: PA aneurysms are a real entity, and surgical repair can be done with low morbidity and mortality. Aneurysmorrhaphy or aneurysmectomy can be performed, depending on the anatomic location. Regardless of the size of the PA, we recommend intervention on high-pressure aneurysms due to the occurrence of advanced medial necrosis.

AB - Background: Pulmonary artery (PA) aneurysms are rare and have been reported only in case reports or small series. We reviewed our experience with surgical repair of PA aneurysms. Methods: We reviewed all patients with a true PA aneurysm undergoing cardiac operations between 1995 and 2015. We excluded aneurysms and pseudoaneurysms related to right ventricular outflow tract patches or previous conduits. Results: There were 38 patients (24 women [63%]; mean age, 46 ± 15 years), and 14 patients (37%) were asymptomatic. The main PA was involved 35 patients (92%). The mean aneurysm diameter was 5.8 ± 1.8 cm. The most common associated pathology was pulmonary valve stenosis/regurgitation in 23 patients (64%). High-pressure (right ventricular systolic pressure >35 mm Hg) aneurysms were present in 23 patients. Operative strategies included reduction arterioplasty in 30 patients (79%) and resection with graft interposition in 8 (21%). The average length of stay was 6.0 ± 2.2 days. There were no early deaths. Late deaths occurred in 3 patients (8%) and were noncardiac related. Late reoperations occurred in 8% and were not related to the PA aneurysm. All high-pressure aneurysms and those larger than 8 cm demonstrated advanced medial necrosis on pathologic examination of the specimens. Conclusions: PA aneurysms are a real entity, and surgical repair can be done with low morbidity and mortality. Aneurysmorrhaphy or aneurysmectomy can be performed, depending on the anatomic location. Regardless of the size of the PA, we recommend intervention on high-pressure aneurysms due to the occurrence of advanced medial necrosis.

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