TY  - BOOK
AU  - Cousins, Sebastian 
AU  - Holliday, Tyler
AU  - Khaitan, Puja Guar
AU  - Maini, Aneel
AU  - Wang Memoli, Jessica
TI  - Hemoptysis: unilateral pulmonary artery atresia? a case report
SN  - 1749-8090
PY  - 2023///
KW  - *Heart Defects, Congenital
KW  - *Hypertension, Pulmonary
KW  - *Respiratory Tract Infections
KW  - Dyspnea
KW  - Hemoptysis/et [Etiology]
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Pulmonary Artery/dg [Diagnostic Imaging]
KW  - Pulmonary Artery/su [Surgery]
KW  - Automated
KW  - MedStar Washington Hospital Center
KW  - Medicine/Pulmonary-Critical Care
KW  - Pulmonary/Critical Care Fellowship
KW  - Surgery
KW  - Surgery/Thoracic Surgery
KW  - Case Reports
KW  - Journal Article
N1  - Available online through MWHC library: 2006 - 2007
N2  - BACKGROUND: Asymptomatic, isolated cases of unilateral pulmonary artery atresia may present in adulthood with symptoms such as recurrent respiratory infections, dyspnea, hemoptysis, and pulmonary hypertension. Unlike previously reported patients that underwent surgical management for this pathology, the patient in this report had no chronic history of recurrent respiratory infections, dyspnea, or pulmonary hypertension, making a diagnosis prior to extensive imaging difficult; CASE PRESENTATION: A 55-year-old male presented to our emergency department (ED) with a 3-day history of recurrent cough with 2-3 tablespoons of hemoptysis per episode, chills, and occasional wheezing. A computed tomography angiography (CTA) was performed, which identified a congenital absence of the left pulmonary artery and a right-sided aortic arch. Hypertrophied left intercostal and bronchial arteries were noted to be perfusing the left lung. V/Q scan confirmed a heterogeneous distribution of gas throughout both lung fields with 97% perfusion to the right lung, but no visualization of the left lung on the perfusion images. Given extensive collateral blood supply to the left lung, interventional radiology performed a GELFOAM R embolization of the hypertrophied left bronchial artery and two parasitized arteries from the left subclavian artery to minimize intra-operative blood loss. This was immediately followed by a left thoracotomy, pneumonectomy, intercostal muscle flap placement, and bronchoscopy. The procedure was 360 min long with a total of 1500 cc blood loss that was salvaged and re-infused. No additional blood products were administered. The patient remained intubated post-operatively and was transferred to the surgical intensive care unit. His postoperative course was complicated by troponin leak, rhabdomyolysis, delirium, and ileus, all of which resolved over time. He was discharged home on postoperative day seven and continues to do well one-year later; CONCLUSIONS: The patient in this report presented with several episodes of isolated hemoptysis but unlike previously reported cases of unilateral pulmonary artery atresia, he had no history of recurrent respiratory infections, dyspnea, or pulmonary hypertension. Although unilateral pulmonary artery atresia is a rare diagnosis, in patients with unexplained, isolated hemoptysis, further examination of the vasculature may be warranted, and surgical management may be beneficial in appropriate, symptomatic patients. Copyright © 2023. The Author(s)
UR  - https://dx.doi.org/10.1186/s13019-023-02255-9
ER  -