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Eur J Cardiothorac Surg 2000;18:535-539
© 2000 Elsevier Science NL

Surgical repair of the pulmonary trunk aneurysm

Departments of Thoracic and Cardiovascular Surgery, Sapporo Medical University School of Medicine, South 1, West 16, Chuo-ku, Sapporo, 060-0061, Japan

Received 19 May 2000; received in revised form 2 August 2000; accepted 5 September 2000.

Corresponding author. Tel.: +81-11-611-2111, ext. 3312; fax: +81-11-613-7318

Objective: Aneurysm formation of the pulmonary trunk is rare and there is controversy about optimal treatment for this disease. The aim of this article is to report four patients with pulmonary trunk aneurysm which were managed by surgical repair. Materials and methods: From 1986 to 1997, we performed surgical repair for pulmonary trunk aneurysm in four patients. There was one male and three female patients with a mean age of 63.3 years (range: 54–78 years). Concomitant diseases were cardiac valvular disease in four patients, thoracic aortic dissection in two, atherosclerotic abdominal aortic aneurysm in two, and coronary artery disease in one. All patients were in New York Heart Association functional class III preoperatively. Surgical procedures for the pulmonary trunk aneurysm included Dacron graft replacement in two patients and aneurysmorrhaphy in two. Associated procedures were cardiac valvular operation in three patients with four lesions and right ventricular outflow tract reconstruction (RVOTR) in one. Results: There were no operative mortalities and no late deaths with a mean follow-up period of 6.6 years (range: 2.4–10.0 years). One female patient developed recurrent pulmonary trunk aneurysm 9.5 years after aneurysmorrhaphy, and underwent a second operation where Dacron graft replacement of the aneurysm including pulmonary valve replacement was performed successfully. All patients are now leading normal lives. Conclusions: Surgical management should be considered for large aneurysm of the pulmonary trunk regardless of its etiology and underlying disease to prevent possible rupture with fatal result if the patient has an acceptably low operative risk.

Key Words: Pulmonary trunk aneurysm • Surgical repair • Graft replacement • Aneurysmorrhaphy

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