The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Jamil Aboulhosn - One of the best experts on this subject based on the ideXlab platform.
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hybrid melody Pulmonary valve replacement in an adult with severe Pulmonary hypertension and Pulmonary Artery Aneurysm
Catheterization and Cardiovascular Interventions, 2013Co-Authors: Gwendolyn Derk, Hillel Laks, Jamil AboulhosnAbstract:A 48-year-old female with D-TGA, ventricular septal defect (VSD), Pulmonary stenosis, Pulmonary hypertension (PAH), and total anomalous Pulmonary venous connection underwent hybrid intervention for a Pulmonary Artery (PA) Aneurysm and replacement of a dysfunctional Pulmonary valve (PV). She underwent a hemi-Mustard procedure at 9 years of age but remained cyanotic. She developed atrial fibrillation, heart failure, and functional decline at 43 years of age. A chest CT demonstrated a 6 cm PA Aneurysm that upon re-imaging at 48 years had increased to 11 cm. A catheterization procedure revealed severe PS, PR, residual VSD, severe PAH with a Pulmonary vascular resistance of 30 Wood units. She was evaluated and turned down for heart-lung transplantation at another institution. She was subsequently referred to our institution for heart-lung transplantation but was felt to be at unacceptably high risk given the complexity of her anatomy, imaging suggesting liver cirrhosis and liver biopsy with extensive fibrosis. After extensive discussion of risk and benefits, the patient agreed to proceed with a hybrid intervention, consisting of surgical Aneurysm resection/PA repair, tricuspid valve repair; PV replacement with a Melody valve, and VSD closure. There were no complications and she was discharged home within 2 weeks. Six months post procedure, she is not on oxygen, her resting room air saturation is 94%, and echocardiography shows stable Melody valve function. This case highlights the utility of a hybrid approach in the treatment of an adult with complex congenital heart disease, heart failure and severe PAH, considered at the highest risk for adverse surgical outcomes. The short-term efficacy of the Melody valve in severe PAH is reassuring.
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percutaneous intervention of left main coronary Artery compression by Pulmonary Artery Aneurysm
Catheterization and Cardiovascular Interventions, 2010Co-Authors: Marmar Vaseghi, Jesse W Currier, Jonathan M Tobis, Shelley Shapiro, Jamil AboulhosnAbstract:BACKGROUND: Extrinsic compression of the left main coronary Artery (LMCA) by a Pulmonary Artery Aneurysm (PAA) has become increasingly recognized as an etiology of angina in patients with Pulmonary arterial hypertension (PAH). The purpose of this study was to assess the feasibility and efficacy of LMCA stenting in the treatment LMCA stenosis because of PAA. METHODS: Retrospective analysis of data on patients with PAH who presented with angina and underwent percutaneous intervention of their LMCA compression because of PAA was performed. RESULTS: Five patients (age 51 ± 16 years, all female) with PAH presented with angina and underwent LMCA stenting between 2007 and 2009. Four had positive cardiac enzymes. LMCA compression because of a PAA was diagnosed in all patients with cardiac CT angiography after echocardiography demonstrated an enlarged Pulmonary Artery. LMCA stenting was successfully performed in all patients with resolution of angina and electrocardiographic abnormalities. After a mean follow-up of 16.6 ± 15.7 months (range of 5-39 months), patients remained angina free, no complications of the procedure were noted, and long term stent patency was confirmed in three of the five patients who underwent repeat cardiac CT angiography. CONCLUSIONS: LMCA stenting appears to be a feasible and durable option in patients who present with angina because of compression by PAA. This procedure was well tolerated and is of particular value given the increased surgical risk in patients with PAH.
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percutaneous intervention of left main coronary Artery compression by Pulmonary Artery Aneurysm
Catheterization and Cardiovascular Interventions, 2010Co-Authors: Marmar Vaseghi, Jonathan M Tobis, Shelley Shapiro, Michael S Lee, Jesse Currier, Jamil AboulhosnAbstract:Background: Extrinsic compression of the left main coronary Artery (LMCA) by a Pulmonary Artery Aneurysm (PAA) has become increasingly recognized as an etiology of angina in patients with Pulmonary arterial hypertension (PAH). The purpose of this study was to assess the feasibility and efficacy of LMCA stenting in the treatment LMCA stenosis because of PAA. Methods: Retrospective analysis of data on patients with PAH who presented with angina and underwent percutaneous intervention of their LMCA compression because of PAA was performed. Results: Five patients (age 51 ± 16 years, all female) with PAH presented with angina and underwent LMCA stenting between 2007 and 2009. Four had positive cardiac enzymes. LMCA compression because of a PAA was diagnosed in all patients with cardiac CT angiography after echocardiography demonstrated an enlarged Pulmonary Artery. LMCA stenting was successfully performed in all patients with resolution of angina and electrocardiographic abnormalities. After a mean follow-up of 16.6 ± 15.7 months (range of 5–39 months), patients remained angina free, no complications of the procedure were noted, and long term stent patency was confirmed in three of the five patients who underwent repeat cardiac CT angiography. Conclusions: LMCA stenting appears to be a feasible and durable option in patients who present with angina because of compression by PAA. This procedure was well tolerated and is of particular value given the increased surgical risk in patients with PAH. © 2010 Wiley-Liss, Inc.
Periyasamy J Kuppanna - One of the best experts on this subject based on the ideXlab platform.
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idiopathic Pulmonary Artery Aneurysm with Pulmonary regurgitation
The Annals of Thoracic Surgery, 2010Co-Authors: Nagarajan Muthialu, Vijayakumar Raju, Venkatadevanathan Muthubaskaran, Padmanabhan Chandrasekar, Srinivasan Muralidharan, Periyasamy J KuppannaAbstract:Idiopathic Pulmonary Artery Aneurysms are rare and need a multidisciplinary approach to diagnosis and treatment. Surgery is the treatment of choice, especially when the Aneurysms are large and when they are associated with Pulmonary regurgitation. This report highlights a case in which successful surgical repair preserved the native Pulmonary valve after Pulmonary Artery reconstruction.
Pilar Escribanosubias - One of the best experts on this subject based on the ideXlab platform.
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compression of the left main coronary Artery by a giant Pulmonary Artery Aneurysm
Circulation, 2013Co-Authors: Alfonso Juradoroman, Felipe Hernandezhernandez, Maria J Ruizcano, Maria Teresa Velazquezmartin, Jose M Medina, Ines Perezlopez, Elvira Barriosgarridolestache, Jose Manuel Monterocabezas, Pilar EscribanosubiasAbstract:We present a 70-year–old man who had a past medical history of dilated idiopathic Pulmonary Artery, incidentally diagnosed at the age of 23 years. He was asymptomatic until a year ago when he was admitted for an episode of anginal chest pain in the context of paroxysmal atrial fibrillation. At rapid rates, he showed pathological ST segment descent. A coronary angiography showed a slight stenosis of the left main coronary Artery (LMCA). At that time, the mean Pulmonary Artery pressure was 36 mm Hg. After recovering sinus rhythm, the patient became asymptomatic and was discharged with β-blockers. A year later, the patient was admitted with resting angina. The echocardiogram (Figure A) and the computed tomography-angio showed that the Aneurysm had increased to 80 mm and compressed the LMCA (Figure B). This finding was …
Werner Budts - One of the best experts on this subject based on the ideXlab platform.
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left main coronary Artery and right Pulmonary vein compression by a large Pulmonary Artery Aneurysm
Heart, 2004Co-Authors: Marion Delcroix, Werner BudtsAbstract:Pulmonary Artery Aneurysms are uncommon and may be associated with significant morbidity and mortality. The unique combination of left main coronary Artery and upper right Pulmonary vein compression by a large Pulmonary Artery Aneurysm is reported. Furthermore, the aetiology, clinical manifestations, complications, diagnostic approach, and possible therapeutic interventions are briefly discussed.
Tolunay Sevingil - One of the best experts on this subject based on the ideXlab platform.
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Idiopathıc Pulmonary Artery Aneurysm
The Annals of Thoracic Surgery, 2013Co-Authors: Gunes Orman, Tolga Sinan Güvenç, Mahmut Duymus, Bahattin Balci, Tolunay SevingilAbstract:Pulmonary Artery Aneurysms are rare pathologic conditions of the thoracic cavity. The idiopathic form of the disease is reported very rarely. We report the case of a 16-year-old girl with idiopathic Pulmonary Artery Aneurysm with surface rendered 3-dimensional images of 64-slice computed tomography. A right-sided aortic arch with normal aortic branching was seen. The main Pulmonary Artery was moderately dilated, and there was Aneurysmal dilatation of the right Pulmonary Artery from its origin to the level of the right descending Pulmonary Artery. The maximal diameter of the main Pulmonary Artery was 38 mm; that of the right Pulmonary Artery was 31 to 34 mm. The left Pulmonary Artery was of normal diameter (18.5 mm). There was no other accompanying abnormality. Because the patient had no severe symptoms and there were no signs of Aneurysmic compression or a shunt, she was scheduled for elective Aneurysmectomy.
