Correct!
4. 1 and 3
Bechet’s disease, causes pulmonary arterial aneurysms (2). Pulmonary varices are rare with only 71 cases reported prior to 1988 (3,4). The varices can be divided into congenital and acquired type cases. Most congenital cases develop during embryonic development, whereas acquired cases mainly accompany mitral valve disease, coarctation of the aorta, or pulmonary venous stenosis (4). Acquired varices may be classified into three types, namely: saccular type, tortuous type and confluent type. Most of the varices seen in patients with valvular disease have been of the confluent type (62%), however tortuous-type varices have also been seen in some cases (19%) (4). None of the saccular type cases, however, were accompanied by valvular disease. The location in 71 cases were RLL-60%, LUL- 17%, RUL -8%, RML- 4%, and LLL-4%. There were no prior reports of bilateral lower lobe varices.
The patient underwent pulmonary angiography confirmed the presence of the pulmonary varices (Figure 4).
Figure 4. Sequential images from the pulmonary angiogram demonstrating the presence of the varices.
Pulmonary artery pressure was normal.
Which of the following should be done to treat pulmonary varices? (Click on the correct answer to be directed to the seventh and last page)