[Thrombosed giant proximal pulmonary artery aneurysm].
We present a 36-year-old male patient with a previous diagnosis (22 years) of Eisenmenger's syndrome, who had a giant proximal pulmonary artery aneurysm complicated by massive thrombus formation. The patient experienced paroxysmal atrial fibrillation attacks for the past month. His functional capacity was New York Heart Association class III. Chest radiography showed aneurysmal dilatation in the left pulmonary artery. The patient was assessed by transthoracic echocardiography and multislice computed tomography. There was mild narrowing in the thick and calcified pulmonary valve (peak systolic gradient 35 mmHg) and moderate regurgitation. The mean pulmonary artery pressure was estimated as 50 mmHg. The diameters of the main, left, and right pulmonary arteries were 6.5 cm, 10 cm, and 3.7 cm, respectively. There was a massive thrombus in the aneurysmatic left pulmonary artery. The patient was referred to the cardiovascular surgery department for pulmonary artery reconstruction and cardiopulmonary transplantation. In addition, medical treatment was instituted with warfarin for thrombus and paroxysmal atrial fibrillation, metoprolol for atrial fibrillation, and bosentan for pulmonary hypertension. The patient's functional capacity showed improvement after the first month of medical treatment and no complications were seen within a year follow-up.
Uçar
Ozgül
O
Department of Cardiology, Ankara Numune Training and Research Hospital, Ankara, Turkey. ozgul_ucar@yahoo.com
Sahin
Deniz
D
Vural
Murat
M
Aydoğdu
Sinan
S
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000209:etiology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D002648:Child; D003330:Coronary Vessel Anomalies / Q000000981:diagnostic imaging; D004541:Eisenmenger Complex / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D011655:Pulmonary Embolism / Q000150:complications* / Q000000981:diagnostic imaging; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D014859:Warfarin; D008790:Metoprolol