Outcome of Surgical Repair of Pulmonary Artery Aneurysms: A Single-Center Experience With 38 Patients

Background Pulmonary artery (PA) aneurysms are rare and have been reported only in case reports or small series. We reviewed our experience with surgical repair of PA aneurysms. Methods We reviewed all patients with a true PA aneurysm undergoing cardiac operations between 1995 and 2015. We excluded aneurysms and pseudoaneurysms related to right ventricular outflow tract patches or previous conduits. Results There were 38 patients (24 women [63%]; mean age, 46 ± 15 years), and 14 patients (37%) were asymptomatic. The main PA was involved 35 patients (92%). The mean aneurysm diameter was 5.8 ± 1.8 cm. The most common associated pathology was pulmonary valve stenosis/regurgitation in 23 patients (64%). High-pressure (right ventricular systolic pressure >35 mm Hg) aneurysms were present in 23 patients. Operative strategies included reduction arterioplasty in 30 patients (79%) and resection with graft interposition in 8 (21%). The average length of stay was 6.0 ± 2.2 days. There were no early deaths. Late deaths occurred in 3 patients (8%) and were noncardiac related. Late reoperations occurred in 8% and were not related to the PA aneurysm. All high-pressure aneurysms and those larger than 8 cm demonstrated advanced medial necrosis on pathologic examination of the specimens. Conclusions PA aneurysms are a real entity, and surgical repair can be done with low morbidity and mortality. Aneurysmorrhaphy or aneurysmectomy can be performed, depending on the anatomic location. Regardless of the size of the PA, we recommend intervention on high-pressure aneurysms due to the occurrence of advanced medial necrosis.