Pulmonary artery aneurysm (PAA) is mostly encountered in the main trunk of pulmonary artery. Aneurysm of the left branch of the pulmonary artery is more common than that of the right branch. Some patients with PAA become symptomatic and are subjected to correction, while others are discovered incidentally. Large aneurysms become symptomatic due to the phenomenon of local compression. According to the reports, idiopathic PAA can be stable for several decades. When the patient is asymptomatic and shows no causes of structural abnormalities of the heart and pulmonary hypertension, the conservative treatment is recommended [1–3]. In the case of obvious dysfunction of the right ventricle or increased pressure in the pulmonary artery, surgery is recommended [2]. PAA is defined by a diameter of the pulmonary artery greater than 4 cm [4]. It is unclear what size PAA (similar to aortic aneurysm) is likely to indicate an increased risk of complications. Some authors suggest that the increase of idiopathic PAA of >6 cm in those who are symptomatic, particularly in patients with right ventricular dysfunction or increased pressure in the pulmonary artery [2,4], should be surgically corrected.
In this case [5], coronary artery bypass grafting (CABG), with arterial graft to the left anterior descending coronary artery and veins grafts to marginal and right coronary artery, was performed. The patient presented herein was asymptomatic due to PAA and without symptoms of stenocardia after CABG. Transthoracic and transoesophageal echocardiography monitoring showed no change of the right ventricle, pulmonary valve insufficiency together with increasing PAA diameter or development of clinical symptoms in the next 3 years.
Conflict of interest: none declared.
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