An aberrant branch originating from right coronary artery leading to acute right heart failure and massive hemoptysis after cardiac surgery: A case report

Year 2020, , 341 - 344, 30.09.2020

Alkın Yazıcıoğlu , Erdal Şimşek Erdal Yekeler , Omaç Tüfekçioğlu Sadi Kaplan

https://doi.org/10.18663/tjcl.707535

Abstract

Although there are several etiological factors for massive hemoptysis, necrosis and infarction of the lung parenchyma are rare causes. Herein, we describe a case of massive hemoptysis due to infarction and associated necrosis of the lung after cardiac surgery. The reason for necrosis was thrombosis of an aberrant artery originating from the right coronary artery and supplying the upper lobe of the left lung. The thrombosis was observed during an embolization procedure for cessation of hemoptysis. To the best of our knowledge, this is the first case in the literature to report an aberrant artery originating from the right coronary artery and supplying the left lung. Additionally, hemoptysis related to a vascular obstruction of an aberrant artery and related necrosis of parenchyma was uncommon. Finally, an acute right heart failure related to the obstruction of aberrant artery was also uncommon.

Keywords

aberrant artery, coronary artery, hemoptysis, infarction, right heart failure

Kardiyak cerrahi sonrası, akut sağ kalp yetmezliği ve masif hemoptiziye sebep olan, sağ koroner arterden köken alan aberran dal: Olgu sunumu

Abstract

Masif hemoptizi için pek çok etyolojik neden bulunmasına karşın akciğer parankiminin enfarktı ve nekrozuna bağlı hemoptizi nadirdir. Bu sunumda, kardiyak cerrahi sonrası akciğer enfarktı ve nekrozuna bağlı masif hemoptizi olgusu sunulmuştur. Akciğer parankimindeki nekrozun nedeni, sağ koroner arterden köken alan ve sol akciğer üst lobunu besleyen aberran arterin trombozu idi. Tromboz, hemoptizi tedavisi için uygulanan embolizayon işlemi sırasında fark edildi. Literatür taramasında, sağ koroner arterden çıkan aberran dalın sol akciğer üst lobunu beslediği başka olgu bulunmamaktadır. Ayrıca, aberran dalın obstrüksiyonu ve buna bağlı olarak parankim nekrozuna sekonder hemoptizi de nadirdir. Son olarak, aberran dalın obstrüksiyonuna bağlı akut sağ kalp yetmezliği de nadir olarak görülmektedir.

Keywords

aberran arter, koroner arter, hemoptizi, enfarkt, sağ kalp yetmezliği

References

• 1. Yazicioglu A, Yekeler E, Yazici U, Aydin E, Tastepe I, Karaoglanoglu N. Management of massive hemoptysis: analyses of 58 patients. Turk Thorac J 2016; 17: 148-52.
• 2. Carteaux G, Contou D, Voiriot G et al. Severe Hemoptysis Associated with Bacterial Pulmonary Infection: Clinical Features, Significance of Parenchymal Necrosis, and Outcome. Lung 2018; 196: 33-42.
• 3. Amrhein TJ, Kim C, Smith TP, Washington L. Bronchial Artery Arising from the Left Vertebral Artery: Case Report and Review of the Literature. J Clin Imaging Sci 2011; 1: 62-5.
• 4. Battal B, Saglam M, Ors F, Akgun V, Dakak M. Aberrant right bronchial artery originating from right coronary artery – MDCT angiography findings. Br J Radiol 2010; 83: 101-4.
• 5. Hwang JH, Kim EY, Park SY. Aberrant Bronchial Artery to Non-Sequestrated Left Upper Lobe in Massive Hemoptysis. Tuberc Respir Dis 2015; 78: 380-4.
• 6. Gypen BJ, Poniewierski J, Rouhanimanesh Y et al. Severe Hemoptysis 6 Years After Coronary Artery Bypass Grafting. Ann Thorac Surg 2003; 75: 999-1001.
• 7. Panda A, Bhalla AS, Goyal A. Bronchial artery embolization in hemoptysis: a systematic review. Diagn Interv Radiol 2017; 23: 307-17.