A Case of Isolated Right Pulmonary Artery Agenesis

고립성 우측 폐동맥 형성부전증 1례

  • Kim, Do Youn (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Lee, Jae Sung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Young (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Chang, Yoon Soo (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Hyung Jung (Department of Internal Medicine, Yonsei University College of Medicine) ;
  • Kim, Tae Hoon (Department of Radiology, Yonsei University College of Medicine) ;
  • Ahn, Chul Min (Department of Internal Medicine, Yonsei University College of Medicine)
  • 김도연 (연세대학교 의과대학 내과학교실) ;
  • 이재성 (연세대학교 의과대학 내과학교실) ;
  • 김영 (연세대학교 의과대학 내과학교실) ;
  • 장윤수 (연세대학교 의과대학 내과학교실) ;
  • 김형중 (연세대학교 의과대학 내과학교실) ;
  • 김태훈 (연세대학교 의과대학 진단방사선과학교실) ;
  • 안철민 (연세대학교 의과대학 내과학교실)
  • Received : 2004.07.03
  • Accepted : 2004.09.15
  • Published : 2004.11.30

Abstract

Unilateral pulmonary artery agenesis is a rare congenital anomaly usually associated with other cardiovascular anomalies such as tetralogy of Fallot or septal defect. Unilateral pulmonary artery agenesis without other coexisting cardiovascular abnormality (isolated unilateral pulmonary artery) is extremely rare and often asymptomatic until adulthood. In these patients, diagnostic clue is found in a plain chest roentgenogram, showing a hyperlucent contracted hemithorax. We have recently experienced a case of isolated right pulmonary artery agenesis, which was diagnosed by chest dynamic CT, perfusion scan, echocardiogram and 3-dimensional reconstruction cardiac CT angiography in a 50-year old female who had suffered from mild dyspnea on exertion and improved with conservative treatment. We report this case with a brief review of the relevant literature.

일측성 폐동맥 형성부전증은 매우 드문 선천성 기형으로서 대부분 팔로사징, 심실중격결손등과 같은 선천성 심기형을 동반하며 선천성 심기형이 동반되지 않은 고립성 편측 폐동맥 형성부전증은 극히 드물다. 이러한 환자들의 경우 성인이 될때까지 무증상으로 지내는 경우가 많으며 흉부 방사선 검사상 병변측 폐의 폐음영은 과투과되어 나타나며 흉곽은 작아진 소견으로부터 고립성 편측 폐동맥 형성부전증을 의심하게 된다. 저자들은 경미한 운동시 호흡곤란을 증상으로 내원한 50세 여환에서 흉부 전산화 단층촬영 및 환기-관류 스캔과 심초음파검사를 시행하고, 삼차원 재구성 전산화 심혈관 단층촬영을 이용하여 고립성 우측 폐동맥 형성부전증을 진단하고 치료한 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

Keywords

References

  1. Ten Harkel AD, Blom NA, Offenkamp J. Isolated unilateral absence of a pulmonary artery: A Case Report and Review of the Literature. Chest 2002;122:1471-7
  2. Kim YH, Jo KH, Kwack MS, Kim SW, Lee HK. Left pulmonary artery agenesis. Kor J Thoracic Cardio vase surgery 1991;24:83-7
  3. Apostolopoulou SC, Kelekis NL, Brountzos EN. Absent pulmonary artery in one adult and five pediatric patients: imaging, embryology, and therapeutic implications. Am J Raentgenol 2002;179:1253-60
  4. Shakibi JG, Rastan H, Nazarian I, Paydar M, Aryanpour I, Sizssi B. Isolated unilateral absence of the pulmonary artery: review of the world literature and guidelines for surgical repair. Jpn Heart J 1978;19:439-51
  5. Bouros D, Pare P, Panagou P, Tsintiris K, Siafakas N. The varied manifestation of pulmonary artery agenesis in adulthood Chest 1995;108:670-6
  6. Brassard JM, Johnson JE. Unilateral absence of pulmonary artery: data from cardiopulmonary exercise testing. Chest 1993;103:293-5
  7. Werber J, Ramio JL, London R, Harris VJ. Unila teral absence of a pulmonary artery of a pulmonary artery. Chest 1983;84:729-32
  8. Werber J, Ramio JL, London R, Harris VJ. Unila teral absence of a pulmonary artery of a pulmonary artery. Chest 1983;84:729-32
  9. Hackett PH, Creagh CE, Grover RF, Honigman B, Houston CS, Reeves Jt, at al. High-altitude pulmonary edema in persons without the right pulmonary artery. N Engl J Hed 1980;302:1070-3
  10. Scherrer U, Volllenweider L, Delabays A, Savcic M Eichenberger U, Kieger gr, et al. Ingaled nitric oxide for high-altitude pulmonary edema. N Engl J Med 1996;334: 624-9
  11. Bouros DE, Panagou PV. Agenesis of the Lung. Eur Respir J. 1990;103;379-90