钙化肺动脉导管远端栓塞：成人先天性心脏病后rastelli的挑战。

Q4 Medicine

JACC. Case reports Pub Date : 2025-10-01 DOI:10.1016/j.jaccas.2025.105241

Maethas Panyawongkhanti MD, MSc , Sopida Thammongkolchai MD, MSc , Niracha Atanavanich MD , Monravee Tumkosit MD , Sarawut Siwamogsatham MD, MSc

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引用次数: 0

摘要

背景：Rastelli手术是先天性心脏病（CHD）的标准手术修复。长期生存率的提高揭示了以前未被认识到的罕见并发症。病例总结：我们报告了一个独特的病例患者的历史拉斯泰利修复谁提出了左侧心力衰竭。诊断检查显示一钙化的肺动脉导管和多处肺栓塞（PE），推测起源于导管碎片。PE最初被非特异性心衰症状所掩盖。多模态心血管成像对诊断至关重要。讨论：这是第一例来自Rastelli患者退变肺动脉导管的钙化PE。虽然右心室流出道并发症是已知的，但钙相关的栓塞现象尚未得到充分认识。本病例突出了一种罕见但重要的并发症，可能随着冠心病生存率的提高而增加。关键信息：冠心病患者的监测成像对于发现晚期结构性并发症至关重要。个体化治疗对于罕见的PE病因至关重要。

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Calcified Pulmonary Artery Conduit With Distal Embolism

Background

The Rastelli procedure is a standard surgical repair for congenital heart disease (CHD). Improved long-term survival has revealed rare complications previously unrecognized.

Case Summary

We report a unique case of a patient with a history of Rastelli repair who presented with left-sided heart failure. Diagnostic workup revealed a calcified pulmonary artery conduit and multiple sites of pulmonary embolism (PE) presumed to originate from fragments of the conduit. The PE was initially masked by nonspecific heart failure symptoms. Multimodality cardiovascular imaging was essential for diagnosis.

Discussion

This is the first reported case of calcified PE from a degenerated pulmonary artery conduit in a Rastelli patient. While right ventricular outflow tract complications are known, calcium-related embolic phenomena are underrecognized. This case highlights a rare but significant complication that may increase as CHD survival improves.