Surgical repair of the pulmonary trunk aneurysm

Objective: Aneurysm formation of the pulmonary trunk is rare and there is c ontroversy about optimal treatment for this disease. The aim of this articl e is to report four patients with pulmonary trunk aneurysm which were manag ed by surgical repair, Materials and methods: From 1986 to 1997, we perform ed 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: 5 4-78 years). Concomitant diseases were cardiac valvular disease in four pat ients, thoracic aortic dissection in two, atherosclerotic abdominal aortic aneurysm in two, and coronary artery disease in one. All patients were in N ew York Hear? Association functional class LII preoperatively. Surgical pro cedures for the pulmonary trunk aneurysm included Dacron graft replace ment in two patients and aneurysmorrhaphy in two. Associated procedures were ca rdiac valvular operation in three patients with four lesions and right vent ricular 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 pu lmonary trunk aneurysm 9.5 years after aneurysmorrhaphy, and underwent a se cond operation where Dacron graft replacement of the aneurysm including pul monary valve replacement was performed successfully. All patients are now l eading normal lives. Conclusions: Surgical management should be considered for large aneurysm of the pulmonary trunk regardless of its etiology and un derlying disease to prevent possible rupture with fatal result if the patie nt has an acceptably low operative risk. (C) 2000 Elsevier Science B.V. All rights reserved.