Pulmonary Arterial Thrombosis in Eisenmenger Syndrome Is Associated With Biventricular Dysfunction and Decreased Pulmonary Flow Velocity
Craig S. Broberg, MD*, ,*,
Masuo Ujita, MD ,
Sanjay Prasad, MD ,
Wei Li, MD, PhD*,
Michael Rubens, FRCR,
Bridget E. Bax, PhD||,
Simon J. Davidson, FIBMS CSci¶,
Beatriz Bouzas, MD*,
J. Simon R. Gibbs, MD#,
John Burman, MD¶ and
Michael A. Gatzoulis, MD, PhD*
* Adult Congenital Heart Disease Centre, Royal Brompton Hospital and National Heart Lung Institute, Imperial College School of Medicine, London, England
Division of Cardiology, Oregon Health and Sciences University, Portland, Oregon
Department of Radiology, Royal Brompton Hospital and National Heart Lung Institute, Imperial College School of Medicine, London, England
Cardiovascular Magnetic Resonance Unit, Royal Brompton Hospital and National Heart Lung Institute, Imperial College School of Medicine, London, England
|| Child Health, Department of Clinical Developmental Sciences, St. George’s, University of London, London, England
¶ Department of Haematology, Royal Brompton Hospital and National Heart Lung Institute, Imperial College School of Medicine, London, England
# Hammersmith Hospital, London, England.
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Figure 1 Cardiac MRI SSFP Image in Oblique Axial Plane
The patient has an aneurismal right pulmonary artery (RPA) with a laminar thrombus along its anterior wall (red arrow). Several different signal intensities within the thrombus (yellow arrow) suggest successive laminar build-up in situ rather than an embolic origin. MRI = magnetic resonance imaging; SSFP = steady state free precession.
 Please see the Appendix for accompanying video.
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Figure 2 Computed Tomographic Pulmonary Angiogram
This scan from a patient with a double-inlet left ventricle and large ventricular septal defect shows extensive calcification of the left and right pulmonary arteries (yellow arrows) with circumferential thrombi (red arrows). LPA = left pulmonary artery; RPA = right pulmonary artery.
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Figure 3 Cardiac MRI SSFP Image in Oblique Coronal Plane
The patient has a ventricular septal defect and severe biventricular dysfunction. The RPA is dilated and a large mural thrombus is present along its inferior wall (red arrow). By cine imaging, sluggish flow in the pulmonary artery is visible. MPA = main pulmonary artery; RV = right ventricle; other abbreviations as in Figure 1.
Please see the Appendix for accompanying video.
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