Solitary peripheral pulmonary artery aneurysms. Pathogenesis and surgical treatment

The case of a solitary peripheral pulmonary artery aneurysm in a patient with congenital heart disease and secondary pulmonary hypertension is presented. The aneurysm appeared following an episode of bacterial endocarditis and was probably mycotic in origin. Resection was prompted by a recent increase in size. A successful aneurysmectomy was performed. Lobectomy was the procedure employed in seven other reported cases treated surgically. A brief review of the literature emphasizes the necessity for resection whenever the diagnosis is made to prevent a fatal outcome due to rupture. A classification of pulmonary artery aneurysms based on their etiology is proposed, together with a possible explanation for the pathogenesis of peripheral aneurysms of nonspecific etiology.