Radiological follow-up after surgery for a giant pulmonary artery aneurysm

Pulmonary artery aneurysm (PAA) is a rare cardiovascular condition, with an incidence of 1 per 14,000 autopsies. It is defined as a dilation of the pulmonary artery trunk exceeding 4 cm. Due to the risk of lethal complications such as dissection thrombosis or spontaneous rupture, surgical management is imperative for “giant” or symptomatic aneurysms, although postoperative follow-up protocols are not standardized. A 68-year-old Asian female presented with a 6-month history of progressive chest pain and dyspnea. Computed tomography angiography (CTA) revealed a giant fusiform aneurysm of the pulmonary trunk (PT), measuring 5.17 cm, and the right pulmonary artery branch (RPA), measuring 3.26 cm. Resection and repair of the PT and the RPA were performed via median sternotomy and cardiopulmonary bypass (CPB), using 28 mm and 20 mm Dacron grafts, respectively. Following a favorable postoperative course, the patient was discharged in stable condition, at follow-up, she remains in good health. Surveillance CTA performed 6 weeks postoperatively demonstrated excellent graft patency, restored pulmonary hemodynamics, and the absence of peri-graft collections or anastomotic complications. Surgical resolution of giant fusiform aneurysm of the PT and the RPA is an effective intervention to prevent catastrophic outcomes. Close imaging surveillance is essential during the postoperative period to monitor dynamic changes not only in the reconstructed pulmonary bed but also in other arterial segments, which is decisive for long-term therapeutic success.