Unilateral absence of pulmonary artery: pathophysiology, symptoms, diagnosis and current treatment.
Unilateral absence of pulmonary artery (UAPA) is a rare malformation that can present as an isolated lesion or may be associated with other congenital heart defects. UAPA is often associated with other congenital cardiovascular anomalies, such as tetralogy of Fallot, atrial septal defect, coarctation of aorta, right aortic arch, truncus arteriosus and pulmonary atresia. Diagnosis of UAPA is very difficult and is based on taking a complete medical history, physical examination and imaging examinations. Clinical symptoms include exercise intolerance, haemoptysis and recurrent respiratory infections. Adult patients with UAPA are often asymptomatic. There is no consensus regarding the treatment for UAPA. The therapeutic approach should be based on symptoms of the patient, pulmonary artery anatomy and associated aortopulmonary collaterals. Treatment options for these patients include partial or total pneumonectomy, closure of selected collateral arteries not solely responsible for pulmonary blood flow or a primary versus staged pulmonary artery anastomosis. This review summarizes pathophysiology, symptomatology and current diagnosis and treatment of this disease.
Department of Cardiovascular Diseases, International Clinical Research Centre, St. Anne's Faculty Hospital and Masaryk University, Pekarska 53, 656 91 Brno, Czech Republic; Institute of Normal and Pathological Physiology and Centre of Excellence for Regulatory Role of Nitric Oxide in Civilization Diseases, Slovak Academy of Sciences, Bratislava, Slovak Republic. Electronic address: kruzliakpeter@gmail.com.
Peter
P
Kruzliak
Rao P
RP
Syamasundar
Miroslav
M
Novak
Olga
O
Pechanova
Gabriela
G
Kovacova
D003952:Diagnostic Imaging / Q000379:methods; D006330:Heart Defects, Congenital / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D010808:Physical Examination; D011013:Pneumonectomy; D011237:Predictive Value of Tests; D011651:Pulmonary Artery / Q000002:abnormalities* / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures
Absence unilatérale de l’artère pulmonaire; CT; Cardiopathie congénitale; Computed tomography; Congenital heart disease; MRA; MRI; Magnetic resonance angiography; Magnetic resonance imaging; PA; PHT; Pathophysiologie; Pathophysiology; Pulmonary artery; Pulmonary hypertension; Symptoms; Symptômes; Treatment; UAPA; Unilateral absence of pulmonary artery