Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-27T01:23:29.025Z Has data issue: false hasContentIssue false
  • English
  • Français

Rupture of pulmonary aneurysms in association with long-standing Waterston shunts

Published online by Cambridge University Press:  01 July 2011

Dearbhla A. Hull ,
Elliot Shinebourne ,
Leon Gerlis ,
Andrew G. Nicholson  and
Mary N. Sheppard
Dearbhla A. Hull
Affiliation:
Department of Histopathology, Royal Brompton Hospital, London, UK
Elliot Shinebourne
Affiliation:
Department of Paediatric Cardiology, Royal Brompton Hospital, London, UK
Leon Gerlis
Affiliation:
Department of Paediatric Cardiology, Royal Brompton Hospital, London, UK
Andrew G. Nicholson
Affiliation:
Department of Histopathology, Royal Brompton Hospital, London, UK
Mary N. Sheppard*
Affiliation:
Department of Histopathology, Royal Brompton Hospital, London, UK
*
Correspondence to: Mary N. Sheppard FRCPath, Departments of Histopathology, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK. Tel: 00 44 207351 8424; Fax: 00 44 207351 8293
Get access Rights & Permissions [Opens in a new window]

Abstract

Anastomosis of the ascending aorta to the right pulmonary artery, the so-called Waterston shunt, was undertaken as a palliative procedure for children with cyanotic congenital heart disease due to obstruction of the pulmonary outflow tract with reduced pulmonary blood flow. We present the clinico-pathological correlations in two patients who underwent construction of Waterston shunts as neonates, and subsequently died of ruptured pulmonary aneurysms in adult life. Rupture should, therefore, be recognized as a late complication of this procedure, and be considered in the long-term follow-up of such patients, especially when the shunted lung is hypertensive.

Keywords

Congenital heart diseasepulmonary arterial aneurysmpulmonary hypertension
Type
Clinico-pathological Correlations
Information
Cardiology in the Young , Volume 11 , Issue 1 , January 2001 , pp. 123 - 127
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Rao, PS, RG, Ellison. The cause of kinking of the right pulmonary artery in the Waterston anastomosis. A growth phenomenon. J Thorac & Cardiovasc Surg 1978; 76: 126–129Google Scholar
2.Yamaki, S. Pulmonary vascular disease in shunted and nonshunted patients with tetralogy of Fallot. Tohoku Journal of Experimental Medicine 1990; 162: 109–119Google Scholar
3.Idriss, FS, Cavallo, CA, Nikaidoh, H, Paul, MH, Koopot, R, AJ, Muster. Ascending aorta-right pulmonary artery shunt. J Thorac & Cardiovasc Surg 1976; 71: 49–57Google Scholar
4.Monarrez, CN, Rao, PS, Moore, HV, WB, Strong. False aneurysm of right pulmonary artery. New complication of aorta-right pulmonary artery anastomosis. J Thorac & Cardiovasc Surg 1979; 77: 738–741Google Scholar
5.SL, Jones. Dissecting hematomas of the pulmonary artery: rare and fatal catastrophies. Am J Forensic Med & Pathol 1997; 18: 349–353Google Scholar
6.Deterling, RA, OT, Clagett. Aneurysm of the Pulmonary artery: review of the literature and report of a case. Am Heart J 47 A.D.; 34: 471–498CrossRefGoogle Scholar
7.Bartter, T, Irwin, RS, Nash, G. Aneurysms of the pulmonaty arteries. Chest 1988; 94: 1065–1075Google Scholar
8.Coard, KC, Martin, MP. Ruptured saccular pulmonary artery aneurysm associated with persistent ductus arteriosus. Arch Path & Lab Med 1992; 116: 159–161Google Scholar
9.Onorato, E, Festa, P, Bourlon, F, Yves, L, Ballerini, L. Idiopathic right pulmonary artery aneurysm with pulmonary valve insufficiency. Catheterization & Cardiovascular Diagnosis 1996; 37: 162–165Google Scholar
10.Gebitekin, C, Yilmaz, M, Senkaya, I, Saba, D, Sagdic, K, Ozer, G. Fatal haemoptysis due to pulmonary artery aneurysm in Behcet's disease. Eur J Vase & Endovasc Surg 1997; 13: 233–236CrossRefGoogle ScholarPubMed
11.Nienaber, CA, Spielmann, RP, Montz, R, Bleifeld, W, DG, Mathey. Development of pulmonary aneurysm in primary pulmonary hypertension: a case report. Angiology 1986; 37: 319–324Google Scholar
12.Bowler, RP, Durham, J, MI, Schwarz. Massive hemoptysis from a pulmonary artery aneurysm associated with an emphyse-matous bulla. Chest 1998; 113: 1130–1131Google Scholar
13.Hartshorne, MF, Eisenberg, B. CT diagnosis of a giant central pulmonary artery aneurysm arising quickly after pulmonary embolic disease. Am J Roentgenol 1989; 153: 190–191Google Scholar
14.Davis, SD, Neithamer, CD, Schreiber, TS, TA, Sos. False pulmonary artery aneurysm induced by Swan-Ganz catheter: diagnosis and embolotherapy. Radiology 1987; 164: 741–742Google Scholar
15.Crivello, MS, Hayes, C, Thurer, RL, Kim, D, Cahalane, M. Traumatic pulmonary artery aneurysm: CT evaluation. Journal of Computer Assisted Tomography 1986; 10: 503–505Google Scholar
16.Fang, CC, CC, Tsai. Idiopathic pulmonary artery aneurysm. Journal of the Formosan Medical Association 1996; 95: 873–876Google Scholar
17.Nwaneri, NJ, RL, Fortune. Aneurysm of the pulmonary artery. Rare long term complication of central aorto-pulmonary shunts for congenital heart disease. Report of two cases with review of the literature. J Cardiovasc Surg 1986; 27: 94–99Google Scholar
18.Wekerle, T, Klepetko, W, Taghavi, S, Birsan, T. Lung transplantation for primary pulmonary hypertension and giant pulmonary artery aneurysm. Ann Thoracic Surg 1998; 65: 825–827Google Scholar
19.Sakai, T, Razavi, MK, Semba, CP, Kee, ST, Sze, DY, Dake, MD. Percutaneous treatment of bronchial artery aneurysm with use of transcatheter coil embolization and thoracic aortic stent-graft placement. J Vase Interv Radiol 1998; 9: 1025–1028Google Scholar
20.Fann, JI, DC, Miller. Endovascular treatment of descending thoracic aortic aneurysms and dissections. Surg Clin North Am 1999; 79: 551–574.Google Scholar