Severe Haemoptysis due to Pulmonary Artery Agenesis, About Two Rare but Threatening Case Reports

Unilateral pulmonary artery agenesis (UPAA) is a rare condition that may be asymptomatic or present with recurrent infections and haemoptysis. A 17-year-old patient with severe haemoptysis who was diagnosed with right pulmonary artery agenesis, associated with hypertrophy of the homolateral bronchial arteries and numerous systemic collaterals. Despite three embolisation procedures, a high-risk of recurrence required pneumonectomy. A 45-year-old patient with tetralogy of Fallot and a known left pulmonary artery agenesis presented with 300 mL haemoptysis. The attempt of embolisation and closure of a communication between the circumflex artery and the bronchial arterial network failed, leading to left pneumonectomy. Every case of haemoptysis requires a chest CT scan, among other reasons, in order to identify potential UPAA. Management must be multidisciplinary, often involving surgery.