Anesthetic management of pulmonary artery replacement for idiopathic dilatation of the pulmonary artery with a Kommerell’s diverticulum: a case report

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Abstract

Background: Idiopathic dilatation of the pulmonary artery (IDPA) is a rare condition in which the pulmonary artery dilates without an obvious cause. Pulmonary artery replacement is indicated in severe cases to prevent serious complications. Case presentation: A 59-year-old man was diagnosed with an IDPA of 64 mm and Kommerell’s diverticulum (aortic aneurysm located at the aberrant left subclavian artery). A computed tomography scan revealed slight compression of the aneurysm to the trachea, although not interfering with airway management. The surgical approach was a median sternotomy, and cardiopulmonary bypass was established through aortic and bicaval cannulations. The perioperative course was uneventful. Conclusions: To prevent injury to the dilated pulmonary artery, a strategy for cardiopulmonary bypass and a surgical approach should be discussed beforehand. As dilatation of the pulmonary artery is often complicated by anatomic abnormalities, preoperative evaluation should be aimed at appropriate assessments using imaging modalities.

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Nishioka, A., Takahashi, K., & Maehara, Y. (2021). Anesthetic management of pulmonary artery replacement for idiopathic dilatation of the pulmonary artery with a Kommerell’s diverticulum: a case report. JA Clinical Reports, 7(1). https://doi.org/10.1186/s40981-020-00404-w

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