Isolated Unilateral Pulmonary Artery Agenesis complicated by Symptomatic Aspergilloma.

Isolated unilateral pulmonary artery agenesis is a rare diagnosis. Poor blood flow to the lung parenchyma renders the tissue susceptible to opportunistic infections. We present the unusual case of isolated unilateral pulmonary artery agenesis complicated by aspergilloma. Management options and considerations are discussed.

Acute Respiratory Failure Post Single Lung Transplantation: An Unusual Cause.

Vascular complications of pulmonary vessels post-transplant are rare but are associated with high morbidity and mortality. We describe the first published case of surgical management of pulmonary vein stenosis complicated by early thrombosis post single lung transplantation. This report describes early diagnostic techniques and subsequent management options in such patients where pulmonary vascular complications are a potential.

Pulmonary resection for airway complication after lung transplantation in a patient with cystic fibrosis: a case report.

We report a case of the interdisciplinary management of recurring bronchial stenosis after bilateral sequential single-lung transplantation (BSSLT) in a 35-year-old female with cystic fibrosis. Initial bronchoscopic therapy including balloon dilatation, stenting, and cryotherapy for granulation tissue overgrowth was unsuccessful in maintaining airway patency. In view of the persistent left lower lobe (LLL) atelectasis and fibrosis predisposing to recurrent infections, she was submitted for left lower lobectomy.

Imaging features of isolated unilateral pulmonary artery agenesis presenting in adulthood: a review of four cases.

AIM: To highlight the variation in clinical manifestations, imaging and management of four cases of unilateral pulmonary artery agenesis presenting in adulthood. METHOD: Four patients with unilateral pulmonary artery agenesis were referred to our institution between 1995 and 2005. They underwent a series of investigations, including chest radiography, echocardiography, ventilation perfusion scintigraphy, angiography, computed tomography (CT) and magnetic resonance imaging (MRI). RESULTS: Two of the four patients had absence of the right main pulmonary artery, whilst the remaining two patients had absence of the left main pulmonary artery. One patient showed a restrictive defect on pulmonary function tests. Two patients who had ventilation perfusion scintigraphy showed absent perfusion and reduced ventilation on the affected side. Angiography (where performed), CT and MRI confirmed the anatomy and the presence of multiple collaterals. Bronchiectasis was demonstrated on CT in two patients, with one also demonstrating a mosaic attenuation pattern. One patient had an incidental lung tumour on the side of the agenesis, which was diagnosed as a chondroid hamartoma on histology. Three of the four patients eventually underwent resection of the affected lung. CONCLUSION: Isolated unilateral pulmonary artery agenesis has a non-specific presentation. Awareness of this condition can lead to earlier diagnosis, with cross-sectional imaging making an important contribution.

Bilateral subclavian steal syndrome.

BACKGROUND: Bilateral atherosclerotic subclavian artery occlusion is rare. AIM: To describe the surgical treatment of a patient with symptomatic bilateral subclavian artery occlusion. METHODS: A midline sternotomy and bilateral aorto-subclavian bypass was performed in a male with upper limb, exercise-induced vertigo. RESULTS: Postoperatively symptomatic improvement paralleled an increase in brachial systolic arterial blood pressure readings. CONCLUSION: Bypass grafting is the more durable option for subclavian artery occlusion, as angioplasty with or without stenting is associated with a higher rate of late stenosis.