Anomalous Bronchial Arteries Originating from a Common Bronchial Arterial Trunk Detected by Trans-Esophageal Echocardiography: A Multi-Faceted Imaging Approach

• DOI: 10.14205/2309-4427.2015.03.01.2
• Publication Date: 2015-10-29T08:20:08Z
• Authors: Ahmad Daraghmeh; Saba Darda; Souheil Saba
• Keywords: Bronchial artery; Pulmonary Trunk

A 56-year-old male presented to the hospital with fever, chills and malaise. His past medical history included; coronary artery disease status post bypass graft surgery, chronic severe mitral regurgitation, monoclonal gammopathy of undetermined significance portal vein thrombosis. Vital signs demonstrated a blood pressure 130/70 mmHg, heart rate 110 bpm normal temperature. The physical examination was unremarkable except for an apical pan-systolic murmur. Two sets culture revealed Group B streptococci. transesophageal echocardiogram (TEE) showed mobile vegetation attached valve anterior leaflet regurgitation. Additionally, abnormal continuous turbulent flow systolic augmentation noted posterior main pulmonary trunk. Peak velocity this jet 1.8-2.0 m/s. high aliasing velocity, spectral Doppler profile proximity trunk were consistent aortic origin flow. cardiac CT angiogram completely occluded venous right patent obtuse marginal branch. An incidental finding anomalous common bronchial (BA) arising from proximal descending thoracic aorta. It gave rise large, tortuous small left BA. To best our knowledge is first case report BA detected by TEE. In patient, two mechanisms may explain extensive dilatation tortuosity system: increased atrial regurgitation hypertension