Hence, there was no anastomotic circle around the pulmonary trunk
('annulus of Vieussens').
No main pulmonary trunk
by echocardiogram, and they couldn't find good branch pulmonary arteries.
In my opinion it had just broken off that morning and lodged in her pulmonary trunk
and this is the cause of her sudden demise.
A CT scan of the chest with contrast showed diffuse bilateral confluent ground-glass opacities, septal line thickening with bilateral small pleural effusions, a mildly enlarged right atrium, mildly enlarged mediastinal and hilar lymphadenopathies, and a dilated pulmonary trunk
presence of pulmonary hypertension; main pulmonary trunk
The key finding on CT is an enlarged pulmonary trunk
with normal to diminished peripheral pulmonary arteries (2,12) (Figure 23).
This demonstrated a very dilated right atrium and right ventricle (Figure 1) and a large mass in the pulmonary trunk
extending to both right and left main pulmonary arteries (Figure 2), thus confirming the suspected diagnosis.
He said: "In my opinion, it had just broken off that morning and lodged in her pulmonary trunk
and this is the cause of her sudden death.
In this configuration, there is a high likelihood of sudden death because of an acute-angle takeoff of the left main artery in conjunction with an initial course of the left main coronary artery between the aorta and pulmonary trunk
Peak systolic pressures in both the right ventricle and pulmonary trunk
, however, were identical, indicating the absence of "right ventricular stenosis" despite the appearance thereof from examination of the explanted heart.
Transesophageal echocardiogram confirmed these findings and demonstrated the aorta and pulmonary trunk
to be positioned in a parallel manner (Fig.
A pulmonary computed tomographic angiogram demonstrated a prominent overriding aortic outflow tract with a VSD and no pulmonary trunk
When the chest radiograph cleared, cardiac catheterization disclosed the following pressures in mm Hg: pulmonary artery wedge a wave 34, v 32, and mean 32; pulmonary trunk
55/38; right ventricle 57/29; left ventricle 133/36 and aorta 77/66, yielding a peak systolic pressure gradient of 56 mm Hg; and mean systolic gradient 39 mm Hg.
It has not been related to sudden death, and perhaps the reason is that in all described patients, the LCX passed behind the aorta, and the LAD passed anterior to pulmonary trunk
or through the ventricular septum (4, 5).
Anomalous origin of the right coronary artery (RCA) arising from the pulmonary trunk
(PT) is rare, with an expected incidence of 0.