Anomalous left pulmonary artery without pulmonary artery sling

Although most news surrounding the declining dollar has concentrated on its impact on Canadian shoppers, economists say it is bound to affect the financially strapped health care system too. They point out that many of the good purchased by Canadian hospitals come from the US, and the weak loonie means their price will rise.     

Rupture of an abnormal pulmonary artery with a flow-directed pulmonary artery catheter

Most authors believe that biliary pancreatitis rarely progresses to chronic pancreatitis. Here, we present a case of an 18-yr-old white male with a history of gallstone pancreatitis and pancreatic pseudocyst resulting in radiographic and pathologic evidence of pancreatic calcification over a 16-mo period.     

Absorbable pulmonary artery band

Absorbable pulmonary artery banding may be a useful method of avoiding further operation or angioplasty in patients whose underlying lesion has a natural history of resolution. We report 2 cases of absorbable pulmonary artery banding using braided Dexon. In both cases the bands functioned well initially and were completely resorbed after 2 years and 6 months, respectively.     

Idiopathic pulmonary artery aneurysm

The purpose of this article is to report two cases of pulmonary artery (PA) aneurysm in patients who had no evidence of left-to-right intracardiac shunting or other known relevant etiologies. One patient, a 52-year-old woman, was admitted to the hospital due to exertional palpitation, while the other patient, a 73-year-old woman, came to the hospital because of fever and cough. In both women, chest radiographic findings of a hugely dilated PA were confirmed by computed tomography (CT). In both cases, a ventriculogram showed fusiform dilatation of the main PA without evidence of pulmonary valve stenosis. The results of chest radiography, two-dimensional echocardiography, CT of the thorax, including pulmonary angiography in one patient, were compatible with the diagnosis of PA aneurysm. No specific drug regimen was administered nor was any surgical intervention performed in either patient. Both patients were asymptomatic as of the last telephone follow-up. Idiopathic PA aneurysm is a benign condition with better survival than PA aneurysms of other etiologies, because of the absence of left-to-right intracardiac shunting and significant pulmonary hypertension. PA aneurysm must be considered as part of the differential diagnosis in an enlarged pulmonary trunk seen on chest radiogram, and two-dimensional echocardiography should be performed initially.     

Primary pulmonary artery sarcoma

1. The aim of the present study was to evaluate the effect of grapefruit juice on urinary 6 beta-hydroxycortisol and cortisol excretion in healthy subjects. 2. The ratio of 6 beta-hydroxycortisol/cortisol was significantly decreased (P = 0.036) in the 0-4 h fraction of urine after ingestion of grapefruit juice, but not in the 4-24 h fraction (P = 0.218) or for the compiled data, fraction 0-24 h (P = 0.114). 3. These results indicate that endogenous cortisol metabolism may not only be of hepatic origin, but may also be dependent on the metabolic capacity of cytochrome P450 IIIA (CYP3A) in the gut mucosa. 4. This finding may cast further doubts of the usefulness of the 6 beta-hydroxycortisol/cortisol ratio as an indicator of hepatic CYP3A activity.     

Leiomyosarcoma of the pulmonary artery

Primary leiomyosarcoma of the pulmonary artery is an extremely rare tumor that is frequently misdiagnosed as chronic pulmonary embolism. In the present case, early diagnosis and location in the left pulmonary artery permitted resection by pneumonectomy with total cardiopulmonary bypass.     

Chondrosarcoma of the pulmonary artery

Primary sarcomas of the large vessels are rare. They are observed most commonly in the pulmonary artery. Up to now 28 cases of primary sarcoma of the pulmonary artery have been described in the literature. The clinical features of this disease which presents considerable diagnostic difficulties are dominated by signs of cor pulmonale. In the present paper a primary chondrosarcoma of the pulmonary artery is presented.     

Regional chemotherapy via the pulmonary artery for pulmonary metastases

Regional chemotherapy with Adriamycin via the pulmonary artery produces significantly higher tissue levels in the infused canine lobe than systemic administration. Seven patients with soft tissue sarcomas who had received the maximum dose of Adriamycin and had shown metastatic tumor recurrence to the lungs, received small doses of 10 to 20 mg of Adriamycin in the lobar arteries supplying areas with tumor via a Swan-Ganz catheter, temporarily occluding with its inflated balloon the infused artery. One partial objective regression was noted. A total of 56 injections of Adriamycin was given through individual lobar arteries in the seven patients. This preliminary experience indicates the feasibility and relative safety of the use of the pulmonary artery for regional chemotherapy of pulmonary malignant tumors and suggests further cautious exploration of this method.     

The study on noninvasive evaluation of pulmonary artery pressure by the method of pulmonary artery flow spectrum in chronic pulmonary disease

OBJECTIVE: Pulmonary artery flow spectrum of patients with chronic pulmonary disease were studied in order to find excellent Doppler Indexes reflected pulmonary artery pressure, and establish multiple regression equation for estimating pulmonary artery pressure more accurately. METHODS: During catheterization, 54 patients with chronic pulmonary disease were examined by echocardiography. Fourteen Doppler indexes of spectrum were compared with the pulmonary artery pressure by catheter simultaneously, and multiple regression equations were taken. RESULTS: There were significant correlation between Doppler indexes PEP/AcT, AcVm, VI/(QTxVmax), RVET/QT and pulmonary artery pressure. Two multiple regression equations were deduced: PAPs (kPa) = [9.4 x PEP/AcT-1.4 x AcVm-126.1 x VI/(QT x Vmax) + 75] divided by 7.5 and PAPm (kPa) = [7.5 x PEP/AcT-1.2 x AcVm- 87.7 x VI/(QT X Vmax) + 48] divided by 7.5. CONCLUSIONS: Above two regression equations could be used to noninvasively evaluate pulmonary artery pressure in patients with chronic pulmonary disease.     

Anomalous right coronary artery from the pulmonary artery in Taussig-Bing anomaly

The presence of associated anomalies in patients with double-outlet right ventricle can significantly alter surgical intervention. Preoperative delineation of these anomalies can facilitate surgical planning and improve outcome. We describe a case in which the right coronary artery and anterior descending coronary artery arose from the pulmonary artery in a patient with double-outlet right ventricle with subpulmonary ventricular septal defect (Taussig-Bing anomaly). Recognition of this important anomaly prevented significant intraoperative myocardial damage by altering techniques of cardioplegia administration for myocardial preservation.     

Anomalous origin of the right coronary artery from the pulmonary artery

Anomalous origin of a coronary artery from the pulmonary artery is a relatively rarer congenital anomaly which almost exclusively involves the left coronary artery. A previously healthy 25-year-old woman had a cardiopulmonary arrest. Following resuscitation, investigations revealed an even rarer anomaly, an anomalous right coronary artery arising from the pulmonary artery. Successful surgical repair was accomplished by reimplanting the right coronary artery into the aortic root. The patient is currently asymptomatic 2 years postoperatively. The pertinent literature is reviewed.     

Lung transplantation for primary pulmonary hypertension and giant pulmonary artery aneurysm

We report the case of an 18-year-old patient with a giant pulmonary artery aneurysm and primary pulmonary hypertension who was successfully treated with bilateral lung transplantation and complete reconstruction of the pulmonary artery.