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J Thorac Cardiovasc Surg 2003;126:864-866
© 2003 The American Association for Thoracic Surgery

Brief communications

Bilateral lung transplantation and pulmonary artery reconstruction in a patient with chronic obstructive pulmonary disease and a giant pulmonary artery aneurysm

^a Division of Cardiothoracic Surgery, Washington University School of Medicine, St Louis, Mo, USA
^b Division of Pulmonary Medicine, Washington University School of Medicine, St Louis, Mo, USA

Received for publication December 7, 2002; accepted for publication January 22, 2003.

^* Address for reprints: Seth D. Force, MD, 3108 Queeny Tower, One Barnes Hospital Plaza, St Louis, MO 63110, USA-1013
sethforce@earthlink.net

The first 20% of the full text of this article appears below.

Aneurysms of the pulmonary artery are a rare entity. In a review in 1947, Deterling and Clagett documented only 8 cases in more than 100,000 autopsies. Similarly, there were only 6 cases of pulmonary artery aneurysms in 4000 patients documented from 1785 to 1946.¹ These aneurysms are most commonly found with congenital heart anomalies, but acquired aneurysms may be associated with atherosclerosis, cystic medial necrosis, trauma, infections such as syphilis and endocarditis, or inflammatory processes such as giant cell arteritis. Although many patients with pulmonary artery aneurysms demonstrate pulmonary hypertension, this has not been proven to be a causative factor. In fact, most patients with pulmonary hypertension never have aneurysms. Symptoms are usually vague and may represent manifestations of the primary disease process or may be related to local compression. The disease process leads to rupture and death in approximately 30% of patients, with other deaths resulting from right-sided heart failure or pulmonary embolus.²

Clinical summary

A 64-year-old man with a history of chronic obstructive pulmonary disease and pulmonary hypertension with giant pulmonary artery aneurysms came to our lung transplant center for evaluation. The pulmonary history was significant for tuberculosis treated at 8 months of age and an open lung biopsy performed in 1965 that showed pulmonary fibrosis.

Preoperative pulmonary function tests revealed a forced expiratory volume in 1 second of 0.650 L (20% of predicted) and a diffusing capacity of lung for carbon monoxide of 28.9 (23% of predicted). Lung volumes were consistent with emphysema with a total lung capacity of 139% of predicted and a . . . [Full Text of this Article]

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