Fig. 22

Pulmonary artery aneurysm. A 78-year-old man with advanced congestive heart failure secondary to congenital pulmonary artery stenosis status post multiple corrective surgeries, now presenting with progressive shortness of breath and speaking difficulty despite adequate management of heart failure. Axial CTA image (a) through the mediastinum reveals aneurysmal dilatation of the left pulmonary artery (white arrows). An axial CTA image through the larynx (b) reveals thickening of the left aryepiglottic fold (white arrowhead) and dilatation of the left piriform sinus (black arrow). A coronal CTA image (c) demonstrates effacement of the aortopulmonary window (black arrows) by the pulmonary artery aneurysm (white arrows) with presumed compression of the left recurrent laryngeal nerve