Isolated Unilateral Absence of The Pulmonary Artery
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A 41‐year‐old man was referred to the hospital because of hemoptysis. Chest roentgenogram showed a mediastinal shift with no consolidations (Figure 1). Chest‐enhanced computed tomography showed the absence of the left pulmonary artery from its origin, but the presence of a multitude of small vessels at the hilum from the bronchial, left internal thoracic, and left inferior phrenic arteries (Figure 2).

No other cardiovascular malformations were detected. The diagnosis was isolated unilateral absence of a pulmonary artery (UAPA), which we considered to be the cause of the hemoptysis. He underwent left pneumonectomy, as there was no main pulmonary artery. In contrast, pulmonary venous drainage was anatomically normal. He had no recurrent symptoms during 21 months of follow‐up.

Points Worth Discussion:-
1. Unilateral absence of the pulmonary artery is a rare anomaly and usually occurs in association with other cardiovascular malformations.
2. It is associated with respiratory symptoms, such as dyspnea or hemoptysis; however, approximately 30% of patients with UAPA remain asymptomatic.
3. Surgical treatments, such as lobectomy or pneumonectomy, are considered for patients with UAPA who are severely symptomatic.
4. This patient has been free of hemoptysis after pneumonectomy and experiences no dyspnea even with exercise.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ccr3.2515
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