We report an uncommon case of large ostium secundum atrial septal defect (ASD) with severe pulmonary arterial hypertension, with associated aneurysmal dilatation of the pulmonary arteries (PAs) leading to compression of the left main bronchus and collapse of the entire left lung in a 15-month-old female child. The patient was managed by surgical closure of the ASD, translocation of the right PA anterior to the aorta with PA aneurysmorrhaphy. Left bronchial compression was relieved with complete lung expansion on the third postoperative day.
DeterlingRAJrClagettT. Aneurysm of the pulmonary artery; review of the literature and report of a case. Am Heart J. 1947;34(4):471–499.
2.
SakumaMDemachiJSuzukiJNawataJTakahashiTShiratoK. Proximal pulmonary artery aneurysms in patients with pulmonary artery hypertension: complicated cases. Intern Med. 2007;46(21):1789–1793.
3.
Eugene Blackstone, Frank Hanley, James Kirklin, Nicholas Kouchoukos. Atrial septal defect and partial anomalous pulmonary venous connection. Kirklin Barratt Boyes Cardiac Surgery. Elsevier Saunders; 2013:1156.
4.
KussmanBDGevaTMcgowanFXJr. Cardiovascular causes of airway compression. Pediatr Anesth. 2004;14(1):60–74.
5.
RosenkranzER. Pulmonary stenosis with intact ventricular septum, single pulmonary artery and aneurysms of the pulmonary arteries. In: ArthurEBAlexanderSGGraemeLHHillelLNaunheimSK, eds. Glenn’s Thoracic and Cardiovascular Surgery. Stamford, CT: Appleton and Lange; 1996;2: 1305–1306.
6.
BartterTIrwinRSNashG. Aneurysms of the pulmonary arteries. Chest. 1988;94(5):1065–1075.
7.
StangerPLucasRVJrEdwardsJE. Anatomic factors causing respiratory distress in acyanotic congenital cardiac disease. Special reference to bronchial obstruction. Pediatrics. 1969;43(5):760–769.
8.
BerlingerNTLongCFokerJLucasRVJr. Tracheobronchial compression in acyanotic congenital heart disease. Ann Otol Rhinol Laryngol. 1983;92(4 pt 1):387–390.
9.
LeeSLCheungYFLeungMPNgYKTsoiNS. Airway obstruction in children with congenital heart disease: assessment by flexible bronchoscopy. Pediatr Pulmonol. 2002;34(4):304–311.
10.
DitchfieldMRCulhamJA. Assessement of airways compression by MR imaging in children with aneurysmal pulmonary arteries. Pediatr Radiol. 1995;25(3):190–191.
11.
NairKSCobanogluAM. Idiopathic main pulmonary artery aneurysm. Ann Thorac Surg. 2001;71(5):1688–1690.
12.
HraskaVPhotiadisJSchindlerE. A novel approach to the repair of tetralogy of Fallot with absent pulmonary valve and the reduction of airway compression by the pulmonary artery. Semin Thorac Cardiovasc Surg Pediatr Card Surg Annu. 2009;12(1):59–62.
