Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report

Pulmonary Artery Aneurysm (PAA), defined as greater than 40 mm dilation of the main pulmonary artery wall, in female and above 43 mm in males is a rare and fatal defect. Since there is a high risk for rupture, especially in cases of symptomatic or severe dilatation, surgical intervention is suggest...

Full description

Bibliographic Details
Main Authors: Shadi Zamansaraei, Milad Nazari Sabet, Parvin Bahrami
Format: Article
Language:English
Published: Tehran University of Medical Sciences 2023-07-01
Series:Case Reports in Clinical Practice
Subjects:
Online Access:https://crcp.tums.ac.ir/index.php/crcp/article/view/709
_version_ 1797742523227045888
author Shadi Zamansaraei
Milad Nazari Sabet
Parvin Bahrami
author_facet Shadi Zamansaraei
Milad Nazari Sabet
Parvin Bahrami
author_sort Shadi Zamansaraei
collection DOAJ
description Pulmonary Artery Aneurysm (PAA), defined as greater than 40 mm dilation of the main pulmonary artery wall, in female and above 43 mm in males is a rare and fatal defect. Since there is a high risk for rupture, especially in cases of symptomatic or severe dilatation, surgical intervention is suggested. There is no recommendation about therapeutic methods based on the diameter of the pulmonary aneurysm in pregnancy in the guidelines. In this rare and unique report, we described a 26-year-old pregnant woman with previous history of biologic pulmonary valve replacement referred to the joint clinic of heart disease and pregnancy at 15 weeks of pregnancy because transthoracic echocardiography showed an aneurysm of the main pulmonary artery (55mm). Due to pulmonary artery diameter and risk of dissection, we informed her about the risks and recommended therapeutic abortion, but she refused and, fortunately no complication occurred during close observation in pregnancy and few months later. There is no specific recommendation about therapeutic methods based on the diameter of the pulmonary aneurysm in pregnancy in the guidelines, but referring to the aortic aneurysm guidelines recommendation, pregnancy termination when PA diameter > 5.5 cm because of the higher risk of dissection. Other factors should be considered to determine the risk of dissection in pregnancy include; categorized PA aneurysms to high or low intravascular PA pressure, PA diameter growth rate, and causative mechanisms. Thus, if pregnancy occurs, decisions about each patient will vary depending on risk factors
first_indexed 2024-03-12T14:42:04Z
format Article
id doaj.art-72aef5bf6f364c39b22b8f6bad5b9528
institution Directory Open Access Journal
issn 2538-2683
2538-2691
language English
last_indexed 2024-03-12T14:42:04Z
publishDate 2023-07-01
publisher Tehran University of Medical Sciences
record_format Article
series Case Reports in Clinical Practice
spelling doaj.art-72aef5bf6f364c39b22b8f6bad5b95282023-08-16T05:57:35ZengTehran University of Medical SciencesCase Reports in Clinical Practice2538-26832538-26912023-07-018110.18502/crcp.v8i1.13089Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case ReportShadi Zamansaraei0Milad Nazari Sabet1Parvin Bahrami2Department of Gynecology Surgery, Isfahan University of medical Sciences, Isfahan, Iran.Resident of General Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.Department of Cardiology, Alzahra University Hospital, Isfahan University of Medical Science, Isfahan, Iran. Pulmonary Artery Aneurysm (PAA), defined as greater than 40 mm dilation of the main pulmonary artery wall, in female and above 43 mm in males is a rare and fatal defect. Since there is a high risk for rupture, especially in cases of symptomatic or severe dilatation, surgical intervention is suggested. There is no recommendation about therapeutic methods based on the diameter of the pulmonary aneurysm in pregnancy in the guidelines. In this rare and unique report, we described a 26-year-old pregnant woman with previous history of biologic pulmonary valve replacement referred to the joint clinic of heart disease and pregnancy at 15 weeks of pregnancy because transthoracic echocardiography showed an aneurysm of the main pulmonary artery (55mm). Due to pulmonary artery diameter and risk of dissection, we informed her about the risks and recommended therapeutic abortion, but she refused and, fortunately no complication occurred during close observation in pregnancy and few months later. There is no specific recommendation about therapeutic methods based on the diameter of the pulmonary aneurysm in pregnancy in the guidelines, but referring to the aortic aneurysm guidelines recommendation, pregnancy termination when PA diameter > 5.5 cm because of the higher risk of dissection. Other factors should be considered to determine the risk of dissection in pregnancy include; categorized PA aneurysms to high or low intravascular PA pressure, PA diameter growth rate, and causative mechanisms. Thus, if pregnancy occurs, decisions about each patient will vary depending on risk factors https://crcp.tums.ac.ir/index.php/crcp/article/view/709Pulmonary arteryAneurysmPregnancy
spellingShingle Shadi Zamansaraei
Milad Nazari Sabet
Parvin Bahrami
Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
Case Reports in Clinical Practice
Pulmonary artery
Aneurysm
Pregnancy
title Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
title_full Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
title_fullStr Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
title_full_unstemmed Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
title_short Pulmonary Artery Aneurysm Dilemma in Pregnancy: A Case Report
title_sort pulmonary artery aneurysm dilemma in pregnancy a case report
topic Pulmonary artery
Aneurysm
Pregnancy
url https://crcp.tums.ac.ir/index.php/crcp/article/view/709
work_keys_str_mv AT shadizamansaraei pulmonaryarteryaneurysmdilemmainpregnancyacasereport
AT miladnazarisabet pulmonaryarteryaneurysmdilemmainpregnancyacasereport
AT parvinbahrami pulmonaryarteryaneurysmdilemmainpregnancyacasereport