OBSTRUCTION OF THE RIGHT PULMONARY-ARTERY BY AN AORTIC-ANEURYSM COMPLICATING PREVIOUS CORONARY-BYPASS GRAFTING

We report a case of right main pulmonary artery compression due to a t ype II dissecting aortic aneurysm simulating massive pulmonary artery embolism. Aortic tear and intimal splitting developed around an aortoc oronary bypass graft performed 11 months earlier. Ultrasound detected the aortic aneurysm and pulmonary hypertension, and excluded emboli in the pulmonary artery. Pulmonary angiography explained the lung involv ement, showing compression of the right main pulmonary artery. Coronar y and aortic angiograms demonstrated that the aortic aneurysm develope d around the right venous bypass graft. Surgery confirmed the angiogra phic findings and the pathogenesis of the syndrome. (C) 1994 Wiley-Lis s, Inc.