Left Pulmonary Artery Coarctoplasty by Using the Right Pulmonary Artery Flap Near the Arterial Duct
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Right pulmonary artery
Main Pulmonary Artery
Left pulmonary artery
Left pulmonary artery
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Sling (weapon)
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Objective
To analyze the echocardiographic features of anomalous origin of the pulmonary artery.
Methods
Echocardiographic data of 32 patients with anomalous origin of the pulmonary artery proved by CT or surgical operation in Beijing Military General Hospital from January 2008 to December 2014 were analyzed retrospectively.
Results
Of them, 7 cases were unilateral absence of pulmonary artery (UAPA), 3 cases were anomalous origin of pulmonary artery (AOPA), and 22 cases were pulmonary artery sling (PAS). Among 32 cases, 2 PAS were missed, 1 UAPA case was misdiagnosed and 1 case was merely suspected by transthoracic echocardiography (TTE). The accuracy rate was 90.6% (29/28). The common echocardiographic feature was that the pulmonary trunk and one branch can be displayed normally. The specific echocardiographic features were as follows. In UAPA cases, there was always only one branch of pulmonary artery can be shown. In AOPA cases, an abnormal artery branch can be found at ascending aorta area, and associated with severe pulmonary hypertension. In PAS cases, the left pulmonary artery branch was derived from the distal right pulmonary artery, which could be displayed at high-level pulmonary artery artery long axis plane.
Conclusion
Anomalous origin of the pulmonary artery had special echocardiographic features. Therefore TTE was able to diagnose the disease early and accurately.
Key words:
Heart defect, congenital; Echocardiography; Anomalous origin of pulmonary artery
Left pulmonary artery
Right pulmonary artery
Main Pulmonary Artery
Pulmonary Trunk
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We report a case of an isolated congenital interruption of the right interlobar pulmonary artery with unilateral interstitial lung abnormality. 3D-CT with enhancement showed absent right interlobar pulmonary artery without any other abnormalities of the pulmonary artery and an enlarged inferior phrenic artery. High-resolution CT demonstrated ground-glass opacities, reticular changes, and small cysts in the right middle and lower lobes, which were compatible with interstitial lung abnormality. The patient was diagnosed with an isolated congenital interruption of the right interlobar pulmonary artery since chronic pulmonary thromboembolism, structural heart disease, systemic congenital disease, and systemic vasculitis were ruled out.
Right pulmonary artery
Abnormality
Left pulmonary artery
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Objective To investigate diagnosis value of CT pulmonary arteriography(CTPA) in pulmonary embolism(PE).Methods Twenty PE patients all had the examination of CTPA.Results Twelve cases showed typeⅠ.Among them four located in left pulmonary artery;Three located in right pulmonary artery,and five located in left and right lobar pulmonary artery.There were two cases with typeⅡ.Among them one located in right lower lobe pulmonary artery,one located in left superior pulmonary lobe artery.There were three cases with type Ⅲ.Among them one located in right lower lobe pulmonary artery,one located in left superior lobe pulmonary artery,and one located in more than two lobe pulmonary arteries;Three cases showed type Ⅳ,all them located in segment and inferior pulmonary artery of under double lung.Rate of PE in left and right pulmonary artery,lobe pulmonary artery,segment pulmonary artery and inferior pulmonary artery each was 77.78%,66.67%,60.00%,and 12.50%,respectively.Conclusion CTPA has important diagnosis value in PE.
Left pulmonary artery
Right pulmonary artery
Main Pulmonary Artery
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Patients with unbalanced pulmonary artery growth resulting from pulmonary coarctation are considered unsuitable candidates for the Fontan procedure. Particularly, patients with right isomerism pose a challenge. We aimed to investigate the use of primary central pulmonary artery plasty at initial palliation in patients with right isomerism.We recruited 34 right isomerism patients with pulmonary atresia and pulmonary coarctation who underwent modified Blalock-Taussig shunt with or without primary central pulmonary artery plasty between 1998 and 2014. We classified them into the primary central pulmonary artery plasty (group P) and no primary central pulmonary artery plasty (group N) groups. We retrospectively analyzed reintervention for pulmonary artery after initial palliation, difference in size between the left and right pulmonary arteries, overall survival, success of the Fontan procedure.The group P and group N included 25 and 9 patients, respectively. Five (20%) and six (67%) patients in group P and group N, respectively, required reintervention for pulmonary artery after initial palliation (p = 0.017). No patient underwent reintervention for the pulmonary artery before bidirectional cavopulmonary shunt in group P. There was a significant difference in the bilateral pulmonary artery size balance between the groups before bidirectional cavopulmonary shunt (p = 0.041). The two-lung Fontan procedure was successful in 14 (56%) and 1 (11%) patient in group P and group N.Primary central pulmonary artery plasty may contribute toward improving the balance in the size of the PA and preclude the need for reintervention for PA.
Right pulmonary artery
Left pulmonary artery
Pulmonary atresia
Fontan Procedure
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Left pulmonary artery
Right pulmonary artery
Main Pulmonary Artery
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Objective To image human pulmonary trunk,right pulmonary artery and left pulmonary artery with multislice spiral CT and measure and evaluate pulmonary trunk and right pulmonary artery and left pulmonary artery.Methods 340 normal cases were chose to do the chest enhanced multi-slice spiral CT scan and the images were transmitted to workstation to make a three-dimensional reconstruction.Observing and measuring the pulmonary trunk,right pulmonary artery and left pulmonary artery,and then made analysis for the pulmonary trunk,right pulmonary artery and left pulmonary artery.Results ① Spiral CT scanning and imaging measurement of pulmonary artery diameter is smaller than the X-ray measurement of the pulmonary artery diameter and it has statistic significance (P0.05);② The diameter of pulmonary artery were also significantly different between male and female (P0.05);③ There are differences between the different aging groups for the pulmonary artery (P0.05);④ There was significant statistic difference the right between left pulmonary artery (P0.01) ⑤ Different reconstruction methods have their own superiority,in which,MIP reconstruction can show the pulmonary trunk,left pulmonary artery from right pulmonary artery better than others and its measuring value is more accurate.Conclusion The chest enhanced multi-slice spiral CT scan can display the pulmonary trunk,right pulmonary artery and left pulmonary artery better through threedimensional reconstruction in the workstation than the conventional autopsy method and make a scientific evaluation.Its data is reliable,this method could be used in morphological study with a large scale sample for the organs in living body.
Left pulmonary artery
Right pulmonary artery
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Intrapulmonary artery septation is employed in patients with unbalanced pulmonary artery growth. A baby girl received a systemic pulmonary shunt in the neonatal period and bilateral Glenn shunts in early infancy. Once the Glenn shunts were established, the right pulmonary artery became hypoplastic. We performed intrapulmonary artery septation involving the Glenn shunts to the left pulmonary artery and the systemic pulmonary shunt to the right pulmonary artery. As early as 3 months after intrapulmonary artery septation, right pulmonary artery growth was observed. Eventually, Fontan circulation was achieved with fenestration.
Left pulmonary artery
Right pulmonary artery
Fenestration
Fontan Procedure
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Left pulmonary artery
Right pulmonary artery
Ductus arteriosus
Sling (weapon)
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