4 CONCLUSION
Patients with PAH and giant PAA may be challenging and potentially carry
high surgical risk. These patients should be evaluated by an experienced
heart and lung transplantation centers. Strategies can be variable
depending upon underlying disease, etiology, center dependent expertise,
and resources available. In those patients who are refractory to medical
therapy, transplantation may be the only management option.
Multidisciplinary consensus should be obtained to offer patients
individualised treatment options. Replacement or reconstruction of the
pulmonary trunk is a feasible option for those who do not require
heart-lung transplantation.