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J Thorac Cardiovasc Surg 2006;132:205-206
© 2006 The American Association for Thoracic Surgery

Brief Communication

Extensive dissection of the pulmonary artery treated with combined heart–lung transplantation

W.A. Wuyts, MD, PhD a , P. Herijgers, MD, PhD b , W. Budts, MD, PhD c , W. De Wever, MD d , M. Delcroix, MD, PhD a , *

a Department of Respiratory Medicine, Pulmonary Hypertension, UZ Gasthuisberg, Leuven, Belgium
b Department of Cardiac Surgery, UZ Gasthuisberg, Leuven, Belgium
c Department of Cardiology, UZ Gasthuisberg, Leuven, Belgium
d Department of Radiology, UZ Gasthuisberg, Leuven, Belgium

Received for publication January 27, 2006; accepted for publication March 15, 2006.

* Address for reprints: M. Delcroix, UZ Gasthuisberg, Department of Pneumology, Herestraat 49, B-3000 Leuven, Belgium. (Email: marion.delcroix@uz.kuleuven.be).

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

A case of extensive dissection of the pulmonary artery was seen in a woman with pulmonary arterial hypertension (PAH) with severe interscapular pain. The diagnosis was made on computed tomographic (CT) scan of the chest. This case report shows that in a patient with PAH with thoracic pain, dissection of the pulmonary artery needs to be excluded. The pathogenesis of pulmonary artery dissection is discussed, as well as diagnosis and therapeutic interventions.

Clinical Summary

A 48-year-old white woman had a history of PAH, diagnosed 20 years previously, associated with a ventricular septal defect. She had been treated with diuretics, but because of increased shortness of breath, the oral prostacyclin analog beraprost was initiated. This therapy was discontinued 11 months later, in August 2002, because of therapy-resistant gastritis. The endothelin receptor antagonist bosentan was started but discontinued after 1 year because of abnormal liver function tests. In October 2004, the patient was treated with sitaxsentan at 100 mg/d and did well for 2 months. Then she mentioned increased shortness of breath (New York Heart Association/World Health Organization functional class II-IV), associated with interscapular pain and intermittent fever episodes. On physical examination, there was an increased . . . [Full Text of this Article]




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Home page
 Eur Respir RevHome page
B. Degano, G. Prevot, L. Tetu, O. Sitbon, G. Simonneau, and M. Humbert
Fatal dissection of the pulmonary artery in pulmonary arterial hypertension
Eur. Respir. Rev., September 1, 2009; 18(113): 181 - 185.
[Abstract] [Full Text] [PDF]


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