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- Kothandam Sivakumar, Maruthanayagam Rajan, Gnanapragasam Francis, Krishnaswami Murali, and Velayudhan Bashi.
- Department of Cardiology, MIOT Hospital, Manapakkam, Chennai 600089, India. drkumarsiva@hotmail.com
- Tex Heart Inst J. 2010 Jan 1;37(1):95-8.
AbstractExtrinsic compression of the left main coronary artery by a massively dilated pulmonary artery in patients who have severe pulmonary hypertension can lead to significant myocardial ischemia. A 58-year-old man with a large patent ductus arteriosus and Eisenmenger syndrome presented with angina at rest and worsening heart failure of 3 months' duration. The new symptoms were recognized to be secondary to extrinsic compression of the left main coronary artery ostium by a dilated main pulmonary artery and were successfully relieved by the placement of a metallic stent in the affected segment of the left main coronary artery. Multislice computed tomographic imaging after 6 months showed stent patency and the intimate relation of the stented vessel to the dilated main pulmonary trunk. We discuss diagnostic and management issues pertaining to this uncommon clinical entity.
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