Main pulmonary artery aneurysm

Case contributed by Mr. Jijeesh K Meethal

Presentation

Correction of tetralogy of Fallot with pulmonary atresia four years ago. Now aneurysmal dilatation of the main pulmonary artery.

Patient Data

Age: 4 years
Gender: Female

Combined cardiac and pulmonary CT angiography

CT
  • status post operative correction
  • absence of pulmonary valve, no filling defects
  • increasingly dilated right ventricular outflow tract and main pulmonary artery (compared to a previous scan in 2019)
  • dilated right atria and right ventricle
  • left coronary artery with more posterior origin but normal course and no compression
  • right coronary artery with no significant stenosis
  • right-sided aortic arch
  • normal pulmonary venous return
  • abnormal course of the left brachiocephalic vein coursing between the ascending aorta and the trachea

Case Discussion

A case of pulmonary artery aneurysm after total surgical correction of tetralogy of Fallot with pulmonary atresia including a conduit construction from the right ventricle to the pulmonary artery and closure of a ventricular septal defect four years prior. Increased hemodynamic shear stresses and increased flow due to congenital heart disease can result in giant pulmonary artery aneurysms.

My appreciation extends to Dr Ajay Prashanth D'souza (Head of radiology and consultant pediatric radiologist), Dr Mohammed Anwar (Consultant pediatric radiologist) and Mrs Jukha Shater Ali Ali Al-Badawi (Radiology manager)

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