Operative intervention for a central pulmonary artery pseudoaneurysm

Area of Science:

• Cardiovascular Surgery
• Vascular Surgery
• Diagnostic Imaging

Background:

• Pulmonary artery (PA) pseudoaneurysms are uncommon but serious vascular conditions.
• While endovascular treatments are common, surgical intervention is sometimes necessary.
• Etiology and location influence management strategies for PA pseudoaneurysms.

Observation:

• A patient presented with a central PA pseudoaneurysm of unclear origin, initially managed conservatively.
• Interval imaging revealed rapid enlargement of the pseudoaneurysm, indicating a need for urgent intervention.
• The pseudoaneurysm was located centrally within the pulmonary artery.

Findings:

• Surgical intervention was performed via median sternotomy with anterior PA arteriotomy.
• The pseudoaneurysm was successfully excluded using a bovine pericardial patch.
• The anterior arteriotomy was also closed with a bovine pericardial patch.

Implications:

• This case demonstrates the successful application of open surgical repair for a complex PA pseudoaneurysm.
• Prompt surgical management can be life-saving in cases of rapidly enlarging PA pseudoaneurysms.
• Bovine pericardial patches are effective for reconstructing the pulmonary artery after pseudoaneurysm exclusion.