Pulmonary artery aneurysm associated with mitral valve disease: a grave prognostic sign.

Seven patients with advanced mitral valve disease and systemic pulmonary hypertension subjected to mitral valve replacement without survival are presented here with the common denominator or the characteristic additional finding of aneurysmal dilatation of the pulmonary artery. During the same period 16 other patients with similar degree of valvular dysfunction and systemic pulmonary hypertension underwent mitral valve replacement with nearly 50 percent of them surviving the operation. The only major diflerence between the two groups was the presence of pulmonary artery aneurysm in the former group with uniformly fatal termination. It is suggested that this roentgenographic sign "under the circumstances outlinedn indicates extremely grave prognosis for mitral valve replacement, and, therefore, consideration should be given to either no operative treatment or closed mitral commissurotomy if at all feasible.