Case report: Multimodality imaging of unusual coronary to pulmonary collaterals in chronic thromboembolic pulmonary hypertension

Ansh Goyal; Ryan Avery; Michael J. Cuttica; James D. Flaherty; S. Chris Malaisrie; Ruben Mylvaganam

doi:10.3389/fcvm.2023.1204736

Case report: Multimodality imaging of unusual coronary to pulmonary collaterals in chronic thromboembolic pulmonary hypertension

Ansh Goyal, Ryan Avery, Michael J. Cuttica, James D. Flaherty, S. Chris Malaisrie^*, Ruben Mylvaganam

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

We present unusual coronary-pulmonary collaterals in a 65-year-old CTEPH patient. Perfusion mapping of a dual-energy computed tomography (DECT) study revealed areas of right lung that were minimally perfused despite unilateral occlusion of the right pulmonary artery, leading to the discovery of coronary-pulmonary collaterals via invasive coronary angiography. Pulmonary thromboendarterectomy removed the clot en-bloc. Post-surgery DECT and catheterization confirmed restoration of pulmonary arterial circulation and excellent hemodynamic response. Here, suggestion of perfusion to a proximally obstructed lung with DECT helped to document the presence of rarely documented coronary-pulmonary artery collaterals.

Original language	English (US)
Article number	1204736
Journal	Frontiers in Cardiovascular Medicine
Volume	10
DOIs	https://doi.org/10.3389/fcvm.2023.1204736
State	Published - 2023

Keywords

chronic thromboembolic pulmonary hypertension
collaterals
coronary angiogram
CTEPH
DECT
pulmonary angiography
pulmonary endarterectomy

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.3389/fcvm.2023.1204736

Cite this

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title = "Case report: Multimodality imaging of unusual coronary to pulmonary collaterals in chronic thromboembolic pulmonary hypertension",

abstract = "We present unusual coronary-pulmonary collaterals in a 65-year-old CTEPH patient. Perfusion mapping of a dual-energy computed tomography (DECT) study revealed areas of right lung that were minimally perfused despite unilateral occlusion of the right pulmonary artery, leading to the discovery of coronary-pulmonary collaterals via invasive coronary angiography. Pulmonary thromboendarterectomy removed the clot en-bloc. Post-surgery DECT and catheterization confirmed restoration of pulmonary arterial circulation and excellent hemodynamic response. Here, suggestion of perfusion to a proximally obstructed lung with DECT helped to document the presence of rarely documented coronary-pulmonary artery collaterals.",

keywords = "chronic thromboembolic pulmonary hypertension, collaterals, coronary angiogram, CTEPH, DECT, pulmonary angiography, pulmonary endarterectomy",

author = "Ansh Goyal and Ryan Avery and Cuttica, {Michael J.} and Flaherty, {James D.} and Malaisrie, {S. Chris} and Ruben Mylvaganam",

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doi = "10.3389/fcvm.2023.1204736",

language = "English (US)",

volume = "10",

journal = "Frontiers in Cardiovascular Medicine",

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AU - Goyal, Ansh

AU - Avery, Ryan

AU - Cuttica, Michael J.

AU - Flaherty, James D.

AU - Malaisrie, S. Chris

AU - Mylvaganam, Ruben

N1 - Publisher Copyright: 2023 Goyal, Avery, Cuttica, Flaherty, Malaisrie and Mylvaganam.

PY - 2023

Y1 - 2023

N2 - We present unusual coronary-pulmonary collaterals in a 65-year-old CTEPH patient. Perfusion mapping of a dual-energy computed tomography (DECT) study revealed areas of right lung that were minimally perfused despite unilateral occlusion of the right pulmonary artery, leading to the discovery of coronary-pulmonary collaterals via invasive coronary angiography. Pulmonary thromboendarterectomy removed the clot en-bloc. Post-surgery DECT and catheterization confirmed restoration of pulmonary arterial circulation and excellent hemodynamic response. Here, suggestion of perfusion to a proximally obstructed lung with DECT helped to document the presence of rarely documented coronary-pulmonary artery collaterals.

AB - We present unusual coronary-pulmonary collaterals in a 65-year-old CTEPH patient. Perfusion mapping of a dual-energy computed tomography (DECT) study revealed areas of right lung that were minimally perfused despite unilateral occlusion of the right pulmonary artery, leading to the discovery of coronary-pulmonary collaterals via invasive coronary angiography. Pulmonary thromboendarterectomy removed the clot en-bloc. Post-surgery DECT and catheterization confirmed restoration of pulmonary arterial circulation and excellent hemodynamic response. Here, suggestion of perfusion to a proximally obstructed lung with DECT helped to document the presence of rarely documented coronary-pulmonary artery collaterals.

KW - chronic thromboembolic pulmonary hypertension

KW - collaterals

KW - coronary angiogram

KW - CTEPH

KW - DECT

KW - pulmonary angiography

KW - pulmonary endarterectomy

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Case report: Multimodality imaging of unusual coronary to pulmonary collaterals in chronic thromboembolic pulmonary hypertension

Abstract

Keywords

ASJC Scopus subject areas

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