Page 22 - Journal of Structural Heart Disease Volume 4, Issue 3

Original Scienti c Article
Journal of Structural Heart Disease, June 2018, Volume 4, Issue 3:79-84
DOI: https://doi.org/10.12945/j.jshd.2018.040.18
Received: September 13, 2017 Accepted: September 27, 2017 Published online: June 2018
Pulmonary Arteriopathy in Patients with Mild
Pulmonary Valve Abnormality without Pulmonary
Hypertension or Intracardiac Shunt
Karam Obeid1*, Subeer K. Wadia, MD2, Gentian Lluri, MD, PhD2, Cherise Meyerson, MD3, Gregory A. Fishbein, MD3, Leigh C. Reardon, MD2, Jamil Aboulhosn, MD2
1 Department of Biological Sciences, Old Dominion University, Norfolk, Virginia, USA
2 Department of Internal Medicine, Ahmanson/UCLA Adult Congenital Heart Disease Center, Los Angeles, California, USA 3 Department of Pathology, Ronald Reagan/UCLA Medical Center, Los Angeles, California, USA
Abstract
Background: The natural history of pulmonary artery aneurysms (PAA) without pulmonary hypertension, intracardiac shunt or signi cant pulmonary valvular disease has not been well studied. This study looks to describe the outcome of a cohort of adults with PAA without signi cant pulmonic regurgitation and steno- sis. Imaging modalities utilized to evaluate pulmonary artery (PA) size and valvular pathology are reviewed. Methods: Patients with PAA followed at the Ahmanson/ UCLA Adult Congenital Heart Disease Center were in- cluded in this retrospective analysis. The criteria for patient inclusion were PAA size ≥ 2.5 cm without intra- cardiac shunting, more than mild pulmonary valve ste- nosis and regurgitation, or pulmonary hypertension. PAA size gathered from initial imaging was compared to the most recent to quantify PAA growth over time. CT, MRI and echocardiography results were compared. Result: Eleven patients were included; Eight females and mean age of 57 (range 25-80). Eight patients were > 50 years of age. Five patients had PAA > 4 cm and were ≥ 50 years old. PAA size increased at a mean rate of 0.5 cm over a mean follow-up of 10 years. Echocar- diography demonstrated signi cant correlation to CT/ MRI (r=0.93, p<0.001).
Conclusion: Most PAA cases are present in patients older than 50 years. Long-term follow-up suggests a
benign course without episodes of dissection or rup- ture despite 6/11 patients with PAA ≥ 5 cm. PA dilation progresses slowly over time and does not appear to cause secondary events. Echocardiography correlates well with magnetic resonance imaging and computed tomography and is useful in measuring PAA over time. Copyright © 2018 Science International Corp.
Key Words
Pulmonary artery aneurysm • Pulmonary stenosis • Pulmonary hypertension • Aortic aneurysm
Introduction
Pulmonary artery aneurysm (PAA), as an isolat- ed nding, is a rare condition of unclear clinical sig- ni cance that is not well described in the literature. Deterling and Clagett [1] reported an occurrence of eight PAA in 109,571 post-mortem examinations, corresponding to an estimated prevalence of one PAA per 13,696 necropsies. Greene and Baldwin [3] described four criteria for de ning PAA: 1) Dilation of the pulmonary artery (PA) (including or excluding the branches), 2) lack of intracardiac shunt, 3) lack of chronic cardiac conditions and 4) lack of systemic ar- terial disease.
* Corresponding Author:
Karam Obeid
Department of Biological Scienceså Old Dominion University
110 Mills Godwin Life Sciences Bldg., Norfolk, VA 23529, USA
Tel. +1 757 472 9912; Fax: +1 757 472 9912; E-Mail: kobei001@odu.edu
Fax +1 203 785 3346
E-Mail: jshd@scienceinternational.org http://structuralheartdisease.org/
© 2018 Journal of Structural Heart Disease Published by Science International Corp. ISN 2326-4004
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