Kyobu geka. The Japanese journal of thoracic surgery
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We encountered a 40-year-old male patient diagnosed to have an atrial septal defect combined with pulmonary hypertension and left main coronary artery stenosis of 50% caused by a dilated pulmonary artery. Preoperative Trazoline tolerance test revealed an increase in pulmonary artery pressure from 77/22(40) to 85/24(42), and a decrease in pulmonary vascular resistance from 4.2 U.m2 to 3.6 U.m2. Moreover, his treadmill exercise test was positive. ⋯ The postoperative catheterization examination showed normal pulmonary artery pressure, mild mitral valve regurgitation, and improvement of the left main coronary artery stenosis from 50% to 41%. After 6 months, his treadmill exercise test was negative. We believe that it is important to estimate preoperatively for the possible reversibility of pulmonary hypertension in a patient with an atrial septal defect combined with a left main coronary artery stenosis caused by a dilated pulmonary artery.