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Graft Repair of a Pulmonary Artery Aneurysm
(#2002-23333 ... September 13, 2002)
Adam H. Hamawy, MD, Richard G. Cartledge, MD, Leonard N. Girardi, MD
Department of Cardiothoracic Surgery, Weill Medical College of Cornell University, New York, New York, USA
ABSTRACT
Aneurysm of the main pulmonary artery is a rare anomaly
with a poorly understood pathogenesis. We report the successful
surgical resection and repair of a pulmonary artery
aneurysm using aneurysmectomy and replacement of the pulmonary
artery with Dacron, a procedure with excellent longterm
outcome that eliminates the risk of recurrence. The
65-year-old male patient presented with a marked decrease in
exercise tolerance and worsening dyspnea. He had a history
of pulmonary stenosis diagnosed during childhood, episodic
shortness of breath beginning during his teenage years,
hypertension, and smoking. On physical examination, the
patient appeared generally well. Computed tomographic scan
of the chest revealed an 8-cm aneurysm involving the main
pulmonary artery and pulmonary artery bifurcation. Coronary
angiography showed a massive aneurysm of the main
and left pulmonary arteries, with mild dilation of the proximal
right pulmonary artery. Surgery was performed through
a median sternotomy with the use of normothermic, bicaval
cardiopulmonary bypass. The aneurysm of the main pulmonary
artery and dilated bifurcation of the pulmonary
artery was excised and reconstruction was performed using a
22-mm Dacron graft. The patient's postoperative course was
uneventful. He was discharged to home on postoperative day
5 and was well at 1-month follow-up.
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