Concomitant operation for pulmonary artery aneurysm and pulmonary valve regurgitation

• Published in: General thoracic and cardiovascular surgery Vol. 68; no. 8; pp. 855 - 857
• Main Authors: Takahashi, Yosuke, Shibata, Toshihiko, Sakaguchi, Masanori, Fujii, Hiromichi, Morisaki, Akimasa, Sakon, Yoshito, Yamane, Kokoro, Kishimoto, Noriaki, Murakami, Takashi
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.08.2020; Springer Nature B.V
• Subjects: Aneurysm - complications; Aneurysm - diagnostic imaging; Aneurysm - surgery; Aneurysms; Cardiac Surgery; Cardiology; Case Report; Echocardiography; Heart Defects, Congenital - diagnostic imaging; Heart Defects, Congenital - surgery; Heart Ventricles - physiopathology; Humans; Male; Medical equipment; Medicine; Medicine & Public Health; Middle Aged; Pericardium; Pericardium - transplantation; Pulmonary arteries; Pulmonary Artery - diagnostic imaging; Pulmonary Artery - surgery; Pulmonary Valve - surgery; Pulmonary Valve Insufficiency - complications; Pulmonary Valve Insufficiency - diagnostic imaging; Pulmonary Valve Insufficiency - surgery; Surgery; Surgical Oncology; Thoracic Surgery; Tomography; Tomography, X-Ray Computed; Treatment Outcome; Veins & arteries; Pulmonary valve reconstruction; Pulmonary aneurysm; Ozaki procedure; Pericardium
• ISSN: 1863-6705; 1863-6713
• DOI: 10.1007/s11748-020-01315-4

A 48-year-old man with a pulmonary artery aneurysm was referred to our hospital. Enhanced computed tomography revealed an aneurysm extending from the main trunk to the bilateral pulmonary branch (maximum diameter 6.4 cm) of the artery. Echocardiography revealed moderate pulmonary valve (PV) regurgitation with right ventricle dilatation. Surgery was indicated because of the pulmonary aneurysm and dyspnea on exertion due to moderate PV regurgitation. Intra-operatively, two cusps were found to be normal in shape, whereas a third left-facing cusp was thick and resembled a small ridge. Therefore, we created one neo-cusp with autologous pericardium using a custom-made template and sutured it along a new, predetermined annulus. We then replaced the pulmonary aneurysm with a T-shaped artificial graft. Postoperative echocardiography showed satisfactory movement of the neo-cusp without pulmonary regurgitation and reduced right ventricular size.