A case of isolated bilateral pulmonary arterial calcification diagnosed in utero

Area of Science:

• Cardiology
• Pediatric Cardiology
• Medical Imaging

Background:

• Isolated multiple pulmonary arterial calcification is exceedingly rare, particularly when presenting with severe bilateral peripheral pulmonary arterial stenosis diagnosed prenatally.
• Congenital pulmonary artery abnormalities pose significant diagnostic and therapeutic challenges in neonates and infants.

Observation:

• A fetus was diagnosed with isolated multiple pulmonary arterial calcification and severe bilateral peripheral pulmonary arterial stenosis.
• Initial treatment with bisphosphonate over six months failed to reduce elevated systolic right ventricular pressure, which exceeded left ventricular pressure.

Findings:

• Successful bilateral pulmonary arterioplasty was performed at 13 months of age.
• Post-procedure, the patient exhibited reduced systolic right ventricular pressure and a normalized interventricular septal configuration.
• Non-contrast computed tomography confirmed this as the first reported case of isolated pulmonary artery calcification without other arterial involvement in a living patient.

Implications:

• Pulmonary arterioplasty is a viable and effective treatment for severe pulmonary arterial stenosis secondary to calcification.
• This case highlights the importance of advanced imaging and interventional procedures in managing rare congenital cardiovascular conditions.
• Further research into the etiology and long-term outcomes of isolated pulmonary arterial calcification is warranted.