Atrial septal defect causing angina

2019 ◽  
Vol 27 (7) ◽  
pp. 593-596
Author(s):  
Dhananjay Bansal ◽  
Mohd Javed Banday ◽  
Anubhav Gupta ◽  
Palash Aiyer ◽  
Vijay Grover ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Atrial Septal Defect ◽  
Left Coronary Artery ◽  
Septal Defect ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Main Pulmonary Artery ◽  
Left Main ◽  
Patch Closure

Left coronary artery compression syndrome is characterized by compression of the left main coronary artery between the aorta and an enlarged main pulmonary artery. A 39-year-old woman presented with angina with dyspnea on exertion for two years. Detailed investigations revealed an atrial septal defect, valvular lesions, and severe pulmonary hypertension with left main coronary artery compression. Patch closure of the atrial septal defect, left coronary artery bypass, and valve repair was carried out. The patient recovered well and was asymptomatic on follow-up. The optimal management of such patients is yet to be clarified.

Extrinsic Compression of the Left Main Coronary Artery: A Case of Atrial Septal Defect with Enlarged Pulmonary Artery

2012 ◽  
Vol 15 (3) ◽  
pp. 158 ◽  
Author(s):  
Mehmet U. Ergenoglu ◽  
Halit Yerebakan ◽  
Ergun Demirsoy
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Left Main Coronary Artery ◽  
Left Internal Mammary Artery ◽  
Artery Bypass ◽  
Left Main ◽  
Surgical Closure ◽  
Extrinsic Compression

We report the case of an adult referred to our center with an initial diagnosis of stenosis of the left main coronary artery (LMCA). A preoperative investigation disclosed an atrial septal defect (ASD) with pulmonary artery hypertension. The angiographic studies confirmed the diagnosis and showed external compression of the LMCA by an enlarged pulmonary artery. Surgical closure of the ASD and tricuspid valve ring annuloplasty with coronary artery bypass surgery (left internal mammary artery to left anterior descending artery) were undertaken. Six months after the surgery, the patient is doing well.

Left main coronary artery and aortic root compression associated with atrial septal defect and pulmonary hypertension

2007 ◽  
Vol 118 (2) ◽  
pp. e41-e43 ◽  
Author(s):  
F. Ayşenur Paç ◽  
Deniz N. Çağdaş ◽  
Mahmut Ulaş ◽  
M. Ali Özatik ◽  
Mustafa Paç
Keyword(s):  
Pulmonary Hypertension ◽  
Coronary Artery ◽  
Atrial Septal Defect ◽  
Aortic Root ◽  
Septal Defect ◽  
Left Main Coronary Artery ◽  
Left Main

scholarly journals ANOMALOUS AORTIC ORIGIN OF THE LEFT MAIN CORONARY ARTERY ASSOCIATED WITH ARTERIAL COMPRESSION - CASE REPORT

2020 ◽  
Author(s):  
Davi Tenório ◽  
Leonardo Miana ◽  
Antonio Carlos de Almeida Barbosa Filho ◽  
Monica Gonzales Coronel ◽  
Gustavo Guerreiro ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Pulmonary Artery ◽  
Left Coronary Artery ◽  
Left Main Coronary Artery ◽  
Postoperative Recovery ◽  
Shortness Of Breath ◽  
Left Main ◽  
External Compression ◽  
The Right

Anomalous Aortic Origin of Coronary Artery (AAOCA) is a rare finding, with varied presentation and symptomatology. Increasingly recognized by cardiac imaging, when found it raises questions about the appropriate approach and management. We present a case of an 11-year-old female who presented with episodes of shortness of breath, angina and syncope during exercise. Further investigation demonstrated episodes of nonsustained ventricular tachycardia on Holter and coronary angiotomography revealed that the left coronary artery had an anomalous origin from the right cusp with initial short intramural segment and significant external compression in its initial course between the aorta and the pulmonary artery. Patient was submitted to surgical correction with dissection of left coronary artery posterior to the pulmonary artery, coronary arteriotomy, roof ampliation with autologous pericardium and creation of neo-ostium in aorta. Patient had satisfactory postoperative recovery, was discharged on the fifth day post op, and remains asymptomatic after six months follow-up. Herein we present surgical video and postoperative echo and CT scan.

scholarly journals 1510 Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Left Main Coronary Artery Disease. A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Hennessy ◽  
J A Henry
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Left Main ◽  
Time Points ◽  
Percutaneous Coronary ◽  
All Cause Mortality

Abstract Aim There is still no consensus whether percutaneous coronary intervention (PCI) is as safe and effective as coronary artery bypass grafting (CABG) for left main coronary artery (LMCA) disease. Recent updates from key clinical trials necessitated an updated examination of the literature on this topic. Method A systematic search was performed of the MEDLINE (via PubMed), EMBASE, Cochrane and clinicaltrials.gov databases from inception to December 20th, 2020. Selected studies were analysed using the random effects model. Outcomes measured included all-cause mortality, MACCE, myocardial infarction (MI), stroke and revascularization. Follow up points were 30 days, 1 year, 5 years and 10 years. Results Six RCTs with a total population of 4700 were included in the analysis. For all-cause mortality PCI was non-inferior to CABG at all time points. MACCE favoured PCI at 30 days, and CABG at 5 years. No difference was seen at 1 year and 10 years. MI favoured CABG at 5 years follow up, with no difference seen at 30 days, 1 year or five years. For stroke, PCI was favourable to CABG at 30 days and 1 year, with no difference at 5 years and 10 years. Revascularisation favoured CABG at 1 year and 5 years, with no difference at other time-points. Conclusions PCI may be considered as an alternative to CABG for uncomplicated LMCA disease. More complex lesions may still benefit from CABG. CABG may be of benefit where future revascularisation would rather be avoided. Further clinical trials examining this research question are needed.

Dual Protection Therapy with Staged Coronary Artery Bypass Surgery and Stenting in Patients with Left Main Coronary Artery Stenosis: Long-Term Results from a Single Center

2014 ◽  
Vol 17 (1) ◽  
pp. 47
Author(s):  
I-Chang Hsieh ◽  
Pyng-Jing Lin ◽  
Shang-Hung Chang ◽  
Ming-Jer Hsieh ◽  
Fen-Chiung Lin ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Bypass Surgery ◽  
Left Main Coronary Artery ◽  
Artery Bypass ◽  
Bypass Grafts ◽  
Left Main ◽  
Vein Grafts ◽  
Dual Protection

<p><b>Objective:</b> We evaluated the efficacy and safety of dual protection therapy with staged coronary artery bypass grafting (CABG) and bare-metal stenting (BMS) in patients with left main coronary artery (LMCA) disease.</p><p><b>Background:</b> CABG is currently the preferred therapy for complex LMCA disease; however, the long-term patency rates of these grafts are unsatisfactory, and stenting alone for LMCA may be associated with the potentially fatal consequences of stent thrombosis or restenosis.</p><p><b>Methods:</b> Between January 1997 and October 2005, 42 patients underwent staged bypass surgery and BMS, with the latter procedure performed 2 weeks after the initial CABG. Of these patients, 40 received left internal mammary artery (LIMA) grafts, 34 saphenous vein grafts, 6 radial artery grafts, and 3 right IMA (RIMA) grafts. Minimally invasive bypass surgery was performed in 10 patients.</p><p><b>Results:</b> There were no operative complications. Forty-two stents were implanted in 42 lesions without complications. During the follow-up period of 135 � 55 months, 1 patient died of cancer, 2 of cardiac causes, and 5 patients (12%) experienced target lesion revascularization. The target vessel failure rate was 24%. Forty patients (95%) underwent a 6-month angiographic follow-up. Restenosis was noted in 7 patients (18%). Reocclusion was also noted in 5 LIMA grafts, 5 saphenous vein grafts, 1 radial artery graft, and 1 RIMA graft. Only 1 patient experienced both restenosis of LM stenting and total occlusion of the 2 bypass grafts.</p><p><b>Conclusions:</b> Dual protection therapy with staged CABG and stenting is not an appropriate therapeutic strategy because of unacceptable graft patency rate. A higher occlusive rate of the bypass grafts may result from decreased blood flow because of competing blood flow between the bypass graft and the native coronary vessel.</p>

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