PDF(Pubmed)
Abstract：
BACKGROUND: Aneurysms of the pulmonary arteries and the ascending aorta are rare, and both bear a high mortality risk if left untreated. In general, these entities are primarily caused by etiologies such as hypertension, pulmonary arterial hypertension, infection or congenital disorders. Treatment requires a rapid diagnostic work-up or even immediate surgical intervention in acute cases. Nevertheless, surgery entails serious perioperative risks, in particular in patients with multiple comorbidities.
METHODS: We discuss a 70-year-old woman presented with decompensated heart failure based on severe pulmonary artery hypertension, coincided by a massive pulmonary artery aneurysm with secondary embolism. Additional diagnostic imaging also showed a chronic post-dissection, saccular aneurysm of the ascending aorta. To our knowledge, this simultaneous diagnosis of a saccular aneurysm of the ascending aorta and a large aneurysm of the pulmonary artery with secondary embolism has not yet been described. Nonetheless, conservative treatment was chosen due to extensive pulmonal and cardiovascular comorbidities and the high-risk profile of surgery.
CONCLUSIONS: Extensive aneurysmatic disease of the pulmonary arteries and ascending aorta come with a serious burden of disease, especially if coincided by severe pulmonal and cardiovascular comorbidities. Both conditions can be curatively treated by surgical intervention. However, in every case the risk of surgery and the patient\'s vitality, comorbidities and wishes should be taken into account to formulate an adequate treatment plan. Therefore, shared decision making is of utter importance.
METHODS: We discuss a 70-year-old woman presented with decompensated heart failure based on severe pulmonary artery hypertension, coincided by a massive pulmonary artery aneurysm with secondary embolism. Additional diagnostic imaging also showed a chronic post-dissection, saccular aneurysm of the ascending aorta. To our knowledge, this simultaneous diagnosis of a saccular aneurysm of the ascending aorta and a large aneurysm of the pulmonary artery with secondary embolism has not yet been described. Nonetheless, conservative treatment was chosen due to extensive pulmonal and cardiovascular comorbidities and the high-risk profile of surgery.
CONCLUSIONS: Extensive aneurysmatic disease of the pulmonary arteries and ascending aorta come with a serious burden of disease, especially if coincided by severe pulmonal and cardiovascular comorbidities. Both conditions can be curatively treated by surgical intervention. However, in every case the risk of surgery and the patient\'s vitality, comorbidities and wishes should be taken into account to formulate an adequate treatment plan. Therefore, shared decision making is of utter importance.
摘要：
背景：肺动脉和升主动脉的动脉瘤很少见，如果不及时治疗，两者都有很高的死亡风险。总的来说,这些实体主要是由高血压等病因引起的，肺动脉高压,感染或先天性疾病。在急性病例中，治疗需要快速的诊断检查，甚至需要立即进行手术干预。然而，手术会带来严重的围手术期风险，特别是在患有多种合并症的患者中。
方法：我们讨论了一名70岁的女性，她因严重肺动脉高压而出现失代偿性心力衰竭，同时发生了巨大的肺动脉瘤和继发性栓塞.额外的诊断成像还显示了慢性解剖后，升主动脉囊状动脉瘤。据我们所知,这种同时诊断升主动脉瓣囊状动脉瘤和肺动脉大动脉瘤伴继发性栓塞的方法尚未被描述.尽管如此，选择保守治疗是由于广泛的肺部和心血管合并症以及手术的高风险.
结论：肺动脉和升主动脉的广泛性动脉瘤疾病带来了严重的疾病负担，特别是如果同时有严重的肺心病和心血管合并症。两种情况都可以通过手术干预进行治疗。然而,在每种情况下，手术的风险和患者的活力，应考虑合并症和愿望，以制定适当的治疗计划。因此,共同决策非常重要。
方法：我们讨论了一名70岁的女性，她因严重肺动脉高压而出现失代偿性心力衰竭，同时发生了巨大的肺动脉瘤和继发性栓塞.额外的诊断成像还显示了慢性解剖后，升主动脉囊状动脉瘤。据我们所知,这种同时诊断升主动脉瓣囊状动脉瘤和肺动脉大动脉瘤伴继发性栓塞的方法尚未被描述.尽管如此，选择保守治疗是由于广泛的肺部和心血管合并症以及手术的高风险.
结论：肺动脉和升主动脉的广泛性动脉瘤疾病带来了严重的疾病负担，特别是如果同时有严重的肺心病和心血管合并症。两种情况都可以通过手术干预进行治疗。然而,在每种情况下，手术的风险和患者的活力，应考虑合并症和愿望，以制定适当的治疗计划。因此,共同决策非常重要。
