Frontiers in Cardiovascular Medicine (Jun 2023)

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
https://doi.org/10.3389/fcvm.2023.1204736
Journal volume & issue
Vol. 10

Abstract

Read online

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