Surgical repair of the pulmonary trunk aneurysm.
OBJECTIVE
Aneurysm formation of the pulmonary trunk is rare and there is controversy about optimal treatment for this disease. The aim of this article is to report four patients with pulmonary trunk aneurysm which were managed by surgical repair.


METHODS
From 1986 to 1997, we performed surgical repair for pulmonary trunk aneurysm in four patients. There was one male and three female patients with a mean age of 63.3 years (range: 54-78 years). Concomitant diseases were cardiac valvular disease in four patients, thoracic aortic dissection in two, atherosclerotic abdominal aortic aneurysm in two, and coronary artery disease in one. All patients were in New York Heart Association functional class III preoperatively. Surgical procedures for the pulmonary trunk aneurysm included Dacron graft replacement in two patients and aneurysmorrhaphy in two. Associated procedures were cardiac valvular operation in three patients with four lesions and right ventricular outflow tract reconstruction (RVOTR) in one.


RESULTS
There were no operative mortalities and no late deaths with a mean follow-up period of 6.6 years (range: 2.4-10.0 years). One female patient developed recurrent pulmonary trunk aneurysm 9.5 years after aneurysmorrhaphy, and underwent a second operation where Dacron graft replacement of the aneurysm including pulmonary valve replacement was performed successfully. All patients are now leading normal lives.


CONCLUSIONS
Surgical management should be considered for large aneurysm of the pulmonary trunk regardless of its etiology and underlying disease to prevent possible rupture with fatal result if the patient has an acceptably low operative risk.
Kuwaki
K
K
Departments of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, 060-0061, Sapporo, Japan.
Morishita
K
K
Sato
H
H
Urita
R
R
Abe
T
T
D000368:Aged; D000783:Aneurysm / Q000145:classification / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D001014:Aortic Aneurysm / Q000150:complications; D019917:Blood Vessel Prosthesis Implantation; D003327:Coronary Disease / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006349:Heart Valve Diseases / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011651:Pulmonary Artery; D012008:Recurrence; D012086:Reoperation; D012307:Risk Factors; D012720:Severity of Illness Index; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome