key: cord-0713123-dk6vyk61
authors: Wong, Lye-Yeng; Sukumar, Mithran; Fuss, Cristina; Thanawala, Ruchi
title: Pulmonary Vascular Complication associated with Coronavirus Infection and Role of Lung Resection
date: 2022-04-25
journal: Ann Thorac Surg
DOI: 10.1016/j.athoracsur.2022.04.016
sha: 31086fc3e9e2d0b63461e746f309409b9b1f6df0
doc_id: 713123
cord_uid: dk6vyk61

Pulmonary artery pseudoaneurysms are an uncommon diagnosis and have been minimally described in the Coronavirus (COVID-19) literature. In our case, a 31 year old male presented with severe acute hypoxic respiratory failure, stress cardiomyopathy, and combined septic and cardiogenic shock secondary to COVID-19 pneumonia and Streptococcus anginosus (SAG) bacteremia. The patient had perfusing granulomas eroding into the pulmonary vasculature causing impending hemothorax. Thoracic surgery for infectious pulmonary artery pseudoaneurysms or perfusing granulomas in patients who have had COVID-19 should be performed selectively and with thoughtful perioperative planning as to prevent the life-threatening complications of rupture and bleeding.

The pathophysiology of COVID-19 associated coronavirus is known to cause thrombosis and hemorrhage through mechanisms of endothelial disruption and dysfunction 1 

known to produce pulmonary abscesses 2 . Male patients with comorbidities are a common cohort in which respiratory SAG infection occurs 3 .

A previously healthy 31 year old male presented with severe acute hypoxic respiratory failure, stress cardiomyopathy, and combined septic and cardiogenic shock secondary to pneumonia and Streptococcus anginosus (SAG) bacteremia.

for septic emboli with early central cavitation, acute granulomas versus lung abscesses.

Subsequent CT angiogram showed contrast filling of many of the nodular cavities, concerning for erosion into adjacent pulmonary arteries or pseudoaneurysm formation. The images provided in Figure 1 

Pulmonary artery pseudoaneurysm secondary to COVID-19 treated with endovascular embolisation

Clinical Characteristics of Infections Caused by

The clinical features of respiratory infections caused by the Streptococcus anginosus group

Massive hemoptysis due to Aspergillus-related pulmonary artery pseudoaneurysm in a patient with COVID-19 pneumonia