| Surgical Treatment of Pulmonary Valve Disease Associated with Pulmonary Arterial Dilatation in the Adult: Reports of Two Cases |
(First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan)
| Katsushi Yamashita |
Satoshi Akuzawa |
Hitoshi Terada |
| Naoki Washiyama |
Kazuhiro Ohkura |
Teruhisa Kazui |
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Pulmonary artery (PA) aneurysm
is rare, but its true incidence is unclear, because most
cases remain asymptomatic. The need for surgical treatment
is controversial. We report two cases of surgical treatment
of PA aneurysm associated with pulmonary valve (PV) disease
in adults. Case1: A 54-year-old woman. She underwent pulmonary
valvotomy for pulmonary stenosis (PS) at age 22. She had
suffered from palpitations and dyspnea on effort recently.
Then progressive changes of pulmonary stenosis-regurgitation
(PSR) occurred. After further examinations, she was diagnosed
as having PA aneurysm and right ventricular dysfunction
with PSR, tricuspid regurgitation and paroxysmal atrial
fibrillation. We performed PV replacement, PA aneurysmo-plasty,
tricuspid annuloplasty, cryo-MAZE procedure. Case2: A
70-year-old man sufferd recently from dyspnea on effort.
The dilatation of the pulmonary artery was pointed out
on chest X-ray. PA aneurysm and PS with ventricular arrhythmia
were diagnosed. We performed PV commissurotomy and PA
aneurysmo-plasty. There were no significant findings of
high PA pressure in either case. PA with pulmonary valve
disease in the presence of low pulmonary pressure have
low risk of rupture and dissection. Surgical treatments
are recommended when right ventricular dysfunction or
ventricular arrhythmia secondary to pulmonary valve disease
is present.
Jpn. J. Cardiovasc. Surg. 37: 100-103 (2008) |
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