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Pulmonary Artery Aneurysm: A 10 Year Community Hospital Experience
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A2132 - Pulmonary Artery Aneurysm: A 10 Year Community Hospital Experience
Author Block: S. Chaudhary, A. Wahab, A. Ayaz, S. Dukkipati, W. Alshweiat, R. Kakarala; Internal Medicine, Mclaren, Flint, MI, United States.
Rationale: Pulmonary Artery Aneurysm (PAA), dilation of the proximal pulmonary artery or one of its branches, is a rare occurrence with an incidence of 1 in 14,000 autopsies. There is an ambiguity regarding the treatment of this condition, i.e., surgical management versus watchful waiting. The evidence on PAA is limited and consists mostly of case reports, a few case series and review articles. The aim of this study is to describe the presenting features, diagnostic testing, treatment and the outcomes in patients with PAA who presented to our hospital. Methods: After obtaining RAB and IRB approval, patients who were discharged with a diagnosis of PAA from McLaren-Flint hospital between August 2005 to October 2016 were included in the cases series and analyzed by using descriptive statistics. Results: We reviewed nine cases identified by using ICD-9,10 codes with discharge diagnosis of PAA. Among them, five patients (2 Caucasian, 2 African-American and 1 of unknown ethnicity) were found to be true cases of PAA including 80% females (4 cases) and 20% males (1 case). All of our patients presented with chest pain, dyspnea or hemoptysis on one occasion or the other. Among them, 80% were smokers( >1 pack/year) and 40 % had congenital anomalies (Patent ductus arteriosus, Tetralogy of Fallot). Pulmonary artery hypertension and pulmonary valvular abnormalities (stenosis/regurgitation) were present in 40% of cases whereas one patient had a connective tissue disorder (polymyositis). The diagnosis was made with CT angiography in four patients while one patient had diagnosis during thoracotomy. The locations of PAA included left main (40%), central/main (40%) and right pulmonary artery (20%) with size ranging from 4.5-5.7 cm. One patient was referred to a tertiary center for surgical management (surgery declined given poor surgical candidate) while others were managed conservatively. One patient had a good follow-up of ten years and remained stable without a fatal outcome. Conclusion: Our study, though small and with limited external validity of results, it supported many of the epidemiological, diagnostic and management options currently available in the literature. Moreover, we believe that PAA can be managed conservatively through minimization of risk factors as it rarely progresses but cases where life-threatening complications occur, surgical intervention could be life-saving.
Author Block: S. Chaudhary, A. Wahab, A. Ayaz, S. Dukkipati, W. Alshweiat, R. Kakarala; Internal Medicine, Mclaren, Flint, MI, United States.
Rationale: Pulmonary Artery Aneurysm (PAA), dilation of the proximal pulmonary artery or one of its branches, is a rare occurrence with an incidence of 1 in 14,000 autopsies. There is an ambiguity regarding the treatment of this condition, i.e., surgical management versus watchful waiting. The evidence on PAA is limited and consists mostly of case reports, a few case series and review articles. The aim of this study is to describe the presenting features, diagnostic testing, treatment and the outcomes in patients with PAA who presented to our hospital. Methods: After obtaining RAB and IRB approval, patients who were discharged with a diagnosis of PAA from McLaren-Flint hospital between August 2005 to October 2016 were included in the cases series and analyzed by using descriptive statistics. Results: We reviewed nine cases identified by using ICD-9,10 codes with discharge diagnosis of PAA. Among them, five patients (2 Caucasian, 2 African-American and 1 of unknown ethnicity) were found to be true cases of PAA including 80% females (4 cases) and 20% males (1 case). All of our patients presented with chest pain, dyspnea or hemoptysis on one occasion or the other. Among them, 80% were smokers( >1 pack/year) and 40 % had congenital anomalies (Patent ductus arteriosus, Tetralogy of Fallot). Pulmonary artery hypertension and pulmonary valvular abnormalities (stenosis/regurgitation) were present in 40% of cases whereas one patient had a connective tissue disorder (polymyositis). The diagnosis was made with CT angiography in four patients while one patient had diagnosis during thoracotomy. The locations of PAA included left main (40%), central/main (40%) and right pulmonary artery (20%) with size ranging from 4.5-5.7 cm. One patient was referred to a tertiary center for surgical management (surgery declined given poor surgical candidate) while others were managed conservatively. One patient had a good follow-up of ten years and remained stable without a fatal outcome. Conclusion: Our study, though small and with limited external validity of results, it supported many of the epidemiological, diagnostic and management options currently available in the literature. Moreover, we believe that PAA can be managed conservatively through minimization of risk factors as it rarely progresses but cases where life-threatening complications occur, surgical intervention could be life-saving.
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