OBJECTIVES: This retrospective cohort study aimed to analyse the impact of asymptomatic blebs/bullae on the occurrence of primary spontaneous pneumothorax (PSP) by monitoring the natural course of contralateral blebs/bullae in patients with ipsilateral pneumothorax. METHODS: From January 2003 to December 2017, 1055 patients [age 19.6 ± 3.98 years (mean ± standard deviation), 953 men] experiencing the first episode of unilateral PSP were enrolled in this study, excluding patients aged 30 years or more. The presence, number and maximal size of the blebs/bullae were investigated in contralateral asymptomatic lungs based on high-resolution computed tomography. RESULTS: Multiple and single blebs/bullae were noted in contralateral lungs in 425 (40.3%) and 88 (8.3%) patients, respectively. The median follow-up period was 44.0 (interquartile range 71.5) months. The 1-, 3- and 5-year cumulative occurrence rates of PSP in contralateral lungs were 7.9%, 13.7% and 16.7%, respectively. On multivariable analysis, younger age [hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.12–1.27; P < 0.001) and multiple bullae (HR 4.42, 95% CI 3.06–6.38; P < 0.001) were independent risk factors for spontaneous pneumothorax in the contralateral lung. The 5-year cumulative occurrence rates of PSP were significantly higher in patients with multiple blebs/bullae than in those with no or a single bleb/bulla (28.2% vs 8.5%, respectively; P < 0.001). CONCLUSIONS: Asymptomatic blebs/bullae often lead to PSP. If the patient is eligible for surgery for pneumothorax, preemptive surgery for contralateral bullae could be considered, especially in patients with multiple blebs/bullae.
25 December 2025 in The Journal of Thoracic and Cardiovascular Surgery
It is well known that coronavirus disease 2019 (COVID-19) can affect the vascular endothelium; however, coronary artery aneurysm complicated by COVID-19 in adults has not yet been reported. Herein, we report a case of a newly developed right coronary artery aneurysm in an adult with recent COVID-19 infection. A 66-year-old man was referred for surgical intervention of the right coronary artery aneurysm. His previous coronary angiograms performed 17 months prior revealed no evidence of coronary aneurysm. However, he was confirmed as having COVID-19 four months prior and thereafter newly diagnosed with right coronary artery aneurysm. The further evaluation of the impact of COVID-19 on the occurrence of coronary artery aneurysm may be necessary, considering the alleged correlation between COVID-19 and vascular complications.