1
|
Congenital Absence of the Portal Vein as a Rare Cause of Portopulmonary Hypertension-A Case Study Series. Medicina (B Aires) 2022; 58:medicina58101484. [PMID: 36295644 PMCID: PMC9608572 DOI: 10.3390/medicina58101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 10/01/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
Background. Congenital absence of the portal vein (CAPV) is an extremely rare malformation that is caused by aberrant venous development during embryogenesis and is usually associated with congenital portosystemic shunts (CPSS). This hemodynamic allows mesenteric blood to bypass the liver metabolism and causes an imbalance between vasodilators and vasoconstrictors in the pulmonary circulation, which, again, might lead to the development of secondary portopulmonary hypertension (PoPH). Establishing the exact morphology of the splanchnic venous system is important when evaluating possible therapeutic options (differentiating type I and II CAPV), because some variants enable the closure of the shunt, and this represents a potential cure for pulmonary arterial hypertension (PAH). Once PoPH is diagnosed, complex care in a specialized expert centre is necessary. If possible, CPSS closure is recommended. For long-term successful patient management, specific targeted PAH therapy administration is crucial. Significant morbidity and mortality in these patients may result not only from PAH itself but also due to specific PoPH complications, such as compression of the left main coronary artery by pulmonary artery aneurysm. Case Report. We report on two patients with PoPH due to CAPV and CPSS (without any liver disease) who presented as severe PAH and who, before admission to our expert centre, were misdiagnosed as idiopathic PAH. The case reports also represent our experience with respect to the long-term follow-up and PAH-specific medical treatment of these patients, as well as the possible (even fatal) complications of these rare and complex patients.
Collapse
|
2
|
Cool CJ, Fathini F, Adams I, Saboe A, Kusumawardhani NY, Astuti A, Yahya AF. Eisenmenger syndrome with left main compression syndrome: a case report. BMC Cardiovasc Disord 2022; 22:89. [PMID: 35247981 PMCID: PMC8898490 DOI: 10.1186/s12872-022-02524-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background Left main coronary artery disease secondary to pulmonary artery compression related to Eisenmenger syndrome is an under-suspected condition that can cause fatal outcomes if left untreated. It presents with typical angina but is frequently mistaken for pulmonary hypertension (PH) symptoms. It is now recognized as one of the few important causes of angina in PH. Case presentation A 37-year-old man with a history of unoperated atrial septal defect and Eisenmenger syndrome came to the outpatient department with a chief complaint of angina on exertion. Electrocardiogram showed regular sinus rhythm with right axis deviation, right ventricular hypertrophy, deep T-wave inversion in inferior and anterior leads suggestive of ischemia or strain, and incomplete right bundle branch block. Cardiac CT showed compression of the left main coronary artery due to a dilated main pulmonary artery. Therefore, this patient was diagnosed with Eisenmenger syndrome with left main compression due to dilated pulmonary artery. He was treated successfully with IVUS-guided stent implantation. The patient experienced marked improvement in regular activities, with no recurrence of angina symptoms. Angiography 3 months after the procedure revealed good patency of the stent, without significant stenosis. Conclusions Left main coronary artery compression is a complication that should be suspected in patients with Eisenmenger syndrome presenting with angina symptoms. Non-invasive modalities are recommended for diagnostic evaluation, but the gold-standard technique remains coronary angiography. The best treatment is not well-established, with either myocardial revascularization or PH treatment, but a left main coronary artery stenting procedure is considered an ideal emergent treatment to provide a better quality of life for patients in this condition.
Collapse
|
3
|
Sugiyama K, Koizumi N, Ogino H. Severe Compression of the Left Main Coronary Artery in a Patient with Chronic Thromboembolic Pulmonary Hypertension. Ann Thorac Cardiovasc Surg 2018; 24:251-254. [PMID: 29321385 PMCID: PMC6198001 DOI: 10.5761/atcs.cr.17-00084] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Extrinsic compression of the left main coronary artery (LMCA) can occur in patients with an enlarged pulmonary artery trunk secondary to severe pulmonary hypertension (PH). This phenomenon rarely occurs in PH; moreover, few reports have shown that chronic thromboembolic PH can be a triggering factor for this syndrome. Herein, we describe a patient with extrinsic compression of the LMCA with chronic thromboembolic PH who underwent pulmonary endarterectomy and coronary artery bypass grafting successfully. Intravenous ultrasonography (IVUS) was effective for detecting and assessing the compression.
Collapse
Affiliation(s)
- Kayo Sugiyama
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Nobusato Koizumi
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery, Tokyo Medical University Hospital, Tokyo, Japan
| |
Collapse
|
4
|
Godfrey A, Cajigas HR. A 55-Year-Old Woman With Pulmonary Hypertension, Worsening Dyspnea, and Chest Pain. Chest 2018; 145:642-645. [PMID: 27845638 DOI: 10.1378/chest.13-1735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 08/08/2013] [Indexed: 11/01/2022] Open
Affiliation(s)
- Amanda Godfrey
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Hector R Cajigas
- Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI.
| |
Collapse
|
5
|
Ikegami R, Ozaki K, Ozawa T, Hirono S, Ito M, Minamino T. Percutaneous Coronary Intervention for a Patient with Left Main Coronary Compression Syndrome. Intern Med 2018; 57:1421-1424. [PMID: 29321426 PMCID: PMC5995705 DOI: 10.2169/internalmedicine.9534-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Left main coronary compression syndrome rarely occurs in patients with severe pulmonary hypertension. A 65-year-old woman with severe pulmonary hypertension due to an atrial septal defect suffered from angina on effort. Cardiac computed-tomography and coronary angiography revealed considerable stenosis of the left main coronary artery (LMA) caused by compression between the dilated main pulmonary artery trunk and the sinus of valsalva. Stenting of the LMA under intravascular ultrasound imaging was effective for the treatment of angina. We herein report the diagnosis and management of this condition with a brief literature review.
Collapse
Affiliation(s)
- Ryutaro Ikegami
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Kazuyuki Ozaki
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Takuya Ozawa
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Satoru Hirono
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Masahiro Ito
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan
| |
Collapse
|
6
|
Demerouti E, Manginas A, Petrou E, Katsilouli S, Karyofillis P, Athanassopoulos G, Karatasakis G, Iakovou I, Mihas K, Mastorakou I. Cardiac Dual-source Computed Tomography for the Detection of Left Main Compression Syndrome in Patients with Pulmonary Hyper-tension. Open Cardiovasc Med J 2016; 10:130-7. [PMID: 27499817 PMCID: PMC4951776 DOI: 10.2174/1874192401610010130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 10/20/2015] [Accepted: 11/02/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Left Main Compression Syndrome (LMCS) represents an entity described as the extrinsic compression of the left main coronary artery (LMCA) by a dilated pulmonary artery (PA) trunk. We examined the presence of LMCS in patients with pulmonary hypertension (PH) using dual-source computed tomography (DSCT), as a non-invasive diagnostic tool. METHODS The following parameters were measured: PA trunk diameter (PAD), the distance between PAD and LMCA (LMPA) and the distance between PA and aorta (AoPA). These measurements were related with demographic, echocardiographic, hemodynamic and clinical parameters. Angiography was performed in two patients with LMCS suspected by cardiac computed tomographic angiography. Patients without PH but with angina were examined as controls, using DSCT cardiac angiography to assess the same measurements and to detect the prevalence of coronary artery disease. RESULTS PA diameter value over 40.00 mm has been associated with PH and LMCS. Furthermore, LMCS did not occur at a distance smaller than 0.50 mm between the PA and the LMCA, and did not correlate with the distance between the PA and the aorta or with cardiac index and NT-proBNP. CONCLUSION DSCT may represent the initial testing modality in PH patients with dilated PA trunk to exclude LMCS. A periodical rule-out of this rare entity, as assessed by DSCT, in patients with a severely dilated PA seems to be mandatory for PH patients contributing to survival improvement.
Collapse
Affiliation(s)
| | | | - Emmanouil Petrou
- Division of Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | | | | | | | | | - Ioannis Iakovou
- First Department of Interventional Cardiology, Onassis Cardiac Surgery Center, Athens, Greece
| | | | - Irene Mastorakou
- Imaging Department, Onassis Cardiac Surgery Center, Athens, Greece
| |
Collapse
|
7
|
Pan HC, Wang KY, Liang KW. Left Main Coronary Artery Stenting to Relieve Extrinsic Compression by a Giant Pulmonary Artery Aneurysm in a Patient with Idiopathic Pulmonary Artery Hypertension. Heart Lung Circ 2016; 25:e122-5. [PMID: 27085308 DOI: 10.1016/j.hlc.2016.02.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 02/17/2016] [Indexed: 11/17/2022]
Abstract
Pulmonary artery aneurysm (PAA) is a rare but lethal disease. We present a female patient with idiopathic pulmonary artery hypertension (IPAH)-related PAA, who suffered from unstable angina pectoris. Multi-detector computed tomography and coronary angiogram revealed extrinsic compression of the left main coronary artery (LMCA) caused by a giant PAA with severe ostial stenosis. Intravascular ultrasound showed an oval-shaped ostium of the LMCA, indicating extrinsic compression. After successful LMCA stent implantation, chest pain was greatly relieved. This case illustrates that beyond right ventricle ischaemia and coronary atherosclerotic disease, LMCA compression by PAA should be considered in the differential diagnosis of angina in patients with IPAH related PAA. In addition, intravascular ultrasound can be used to confirm the diagnosis and guide the stent implantation safely.
Collapse
Affiliation(s)
- Hung-Chih Pan
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Kuo-Yang Wang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Medicine, China Medical University, Taichung, Taiwan; Department of Medicine, Chung Shan Medical University, Taichung, Taiwan.
| | - Kae-Woei Liang
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming University, Taipei, Taiwan.
| |
Collapse
|
8
|
Abstract
Pulmonary hypertension is the commonest condition leading to dilated pulmonary artery. We describe three different types of compression of adjacent anatomical structures by dilated pulmonary arteries. We included involvement of the left main coronary artery, left recurrent laryngeal nerve and tracheobronchial tree. Compression of these structures can cause major complications such as myocardial ischemia, hoarseness and major airway stenosis. We present a case for each scenario and review the literature for each of these complications, focusing on patients' characteristics and contemporary management.
Collapse
Affiliation(s)
- Wael Dakkak
- a Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute , Cleveland Clinic , Cleveland , OH , USA
| | - Adriano R Tonelli
- a Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute , Cleveland Clinic , Cleveland , OH , USA
| |
Collapse
|
9
|
Seabra LF, Ribeiro HB, de Barros e Silva PGM, Rodrigues MJ, Spadaro AG, Conejo F, Godinho RR, Faig SMM, de Macedo TA, de P. S. Baptista L, de Resende MVC, Furlan V, Ribeiro EE. Left Main Ostial Compression in a Patient with Pulmonary Hypertension: Dynamic Findings by IVUS. AMERICAN JOURNAL OF CASE REPORTS 2015; 16:899-903. [PMID: 26694602 PMCID: PMC4714914 DOI: 10.12659/ajcr.895668] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2015] [Accepted: 08/27/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pulmonary artery dilatation is a common feature among patients with severe pulmonary hypertension. Left main coronary artery extrinsic compression by an enlarged pulmonary artery is a rare complication and a potential cause for chest pain and sudden cardiac death in patients with pulmonary hypertension. This situation is very rare and few reports have described it. Currently, the appropriate management of these patients remains unknown. CASE REPORT In the present report we describe the case of a 39-year-old woman who presented with a 2-year history of cardiac symptoms related to exercise. The patient underwent a 64-slice multidetector computed tomography (MDCT) coronary angiography, which showed left main coronary artery (LMCA) compression by a markedly enlarged pulmonary artery trunk (44 mm), without intraluminal stenosis or coronary artery calcium, as determined by the Agatston score. This compression was considered to be the cause of the cardiac symptoms. To confirm and plan the treatment, the patient underwent cardiac catheterization that confirmed the diagnosis of pulmonary hypertension and LMCA critical obstruction. Taking into account the paucity of information regarding the best management in these cases, the treatment decision was shared among a "heart team" that chose percutaneous coronary intervention with stent placement. An intra-vascular ultrasound was performed during the procedure, which showed a dynamic compression of the left main coronary artery. The intervention was successfully executed without any adverse events. CONCLUSIONS This case illustrates dynamic compression of the LMCA by IVUS, visually demonstrating the mechanism of the intermittent symptoms of myocardial ischemia in this kind of patient. It also shows that percutaneous stenting technique may be an appropriate treatment for this unusual situation.
Collapse
Affiliation(s)
| | - Henrique B. Ribeiro
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| | | | | | - André G. Spadaro
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| | - Fábio Conejo
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| | - Roger R. Godinho
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| | - Sandro M. M. Faig
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| | | | | | | | | | - Expedito E. Ribeiro
- Department of Interventional Cardiology, Hospital Totalcor, São Paulo, SP, Brazil
| |
Collapse
|
10
|
Yeh DD, Ghoshhajra B, Inglessis-Azuaje I, MacGillivray T, Liberthson R, Bhatt AB. Massive Pulmonary Artery Aneurysm Causing Left Main Coronary Artery Compression in the Absence of Pulmonary Hypertension. Tex Heart Inst J 2015; 42:465-7. [PMID: 26504443 DOI: 10.14503/thij-15-5028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
We report the case of a 62-year-old woman who presented with classic symptoms of stable angina. Cardiac images and catheterization results revealed absent pulmonary valve syndrome and compression of the left main coronary artery by a massively dilated pulmonary artery aneurysm. The patient's anginal symptoms were relieved after pulmonary arterioplasty. Others have described proximal left main coronary artery compression in the presence of a dilated and hypertensive pulmonary artery. To our knowledge, this is the first case in which a pulmonary artery aneurysm caused left main coronary insufficiency in the absence of pulmonary hypertension-a clinically important complication of congenital pulmonary valve-related pulmonary arteriopathy.
Collapse
|
11
|
Alkhouli M, Huda N, Bashir R, Patil P, O'Murchu B. Left main coronary artery compression syndrome and spontaneous coronary artery dissection: coincidence or pathologic association? Heart Lung 2014; 43:284-5. [PMID: 24751338 DOI: 10.1016/j.hrtlng.2014.03.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 03/09/2014] [Accepted: 03/15/2014] [Indexed: 11/17/2022]
Abstract
Left main coronary artery compression syndrome (LMCS) in patients with severe pulmonary arterial hypertension (PAH) is an unusual, and often a missed cause of exertional angina. Spontaneous coronary dissection (SCD) is a rare cause of acute coronary syndrome of unknown etiology, with predilection to women in the 20s-40s. Weather the co-presence of LMCS and SCD in certain patients is a coincidence or of pathological significance is not known. The optimal management strategy of each of these conditions remains controversial. We report a case of SCD in a patient with PAH and LMCS, successfully treated with conservative medical therapy.
Collapse
Affiliation(s)
- Mohamad Alkhouli
- Cardiology Division, Temple University School of Medicine, 3041 N. Broad Street, Suite 945, Parkinson Pavilion, Philadelphia, PA 19140, USA.
| | - Nazmul Huda
- Cardiology Division, Temple University School of Medicine, 3041 N. Broad Street, Suite 945, Parkinson Pavilion, Philadelphia, PA 19140, USA
| | - Riyaz Bashir
- Cardiology Division, Temple University School of Medicine, 3041 N. Broad Street, Suite 945, Parkinson Pavilion, Philadelphia, PA 19140, USA
| | - Pravin Patil
- Cardiology Division, Temple University School of Medicine, 3041 N. Broad Street, Suite 945, Parkinson Pavilion, Philadelphia, PA 19140, USA
| | - Brian O'Murchu
- Cardiology Division, Temple University School of Medicine, 3041 N. Broad Street, Suite 945, Parkinson Pavilion, Philadelphia, PA 19140, USA
| |
Collapse
|
12
|
Kusunose K, Tomita N, Nishio S, Bando M, Hayashi S, Hotchi J, Iwase T, Yamada H, Sata M. Left main coronary artery compression syndrome with an incomplete atrioventricular septal defect presenting as angina induced by hyperthyroidism. Intern Med 2014; 53:2083-5. [PMID: 25224192 DOI: 10.2169/internalmedicine.53.2403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We herein report the case of a 29-year-old woman who was diagnosed with incomplete atrioventricular septal defect and extrinsic compression of the left main coronary artery (LMCA) with chest pain due to postpartum thyroiditis. She exhibited chest pain with ST elevation, and coronary computed tomography showed that the LMCA was compressed between the dilated pulmonary artery and aorta. After her hyperthyroidism was treated, her chest pain resolved. Surgical repair of endocardiosis and coronary bypass grafting were performed. On the one-year follow-up visit, the dilation of the pulmonary artery and right heart was decreased. It is important to consider the possibility of compression of the LMCA in patients presenting with pulmonary hypertension and chest pain.
Collapse
Affiliation(s)
- Kenya Kusunose
- Department of Cardiovascular Medicine, Tokushima University Hospital, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Unruptured aneurysm of the left sinus of Valsalva compressing the left main coronary artery. Herz 2013; 39:770-3. [DOI: 10.1007/s00059-013-3891-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Revised: 06/19/2013] [Accepted: 06/19/2013] [Indexed: 11/27/2022]
|
14
|
Two rare conditions in an Eisenmenger patient: left main coronary artery compression and Ortner's syndrome due to pulmonary artery dilatation. Heart Lung 2013; 42:382-6. [PMID: 23831302 DOI: 10.1016/j.hrtlng.2013.06.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Revised: 05/28/2013] [Accepted: 06/02/2013] [Indexed: 11/23/2022]
Abstract
The left-main coronary artery extrinsic compression due to enlarged pulmonary artery has been described in several case series. Ortner's syndrome is also a rare condition in some cardiovascular disorders. There have been no reports about these two rare conditions in the same patient. Hence, we report a very rare case of an Eisenmenger patient with severe pulmonary hypertension and dilated pulmonary artery which has compressed the left main coronary artery, severely narrowing it, and the left laryngeal recurrent nerve with subsequent Ortner's syndrome and brief literature review.
Collapse
|
15
|
Salhab KF, Al Kindi AH, Ellis SG, Lad N, Svensson LG. Percutaneous coronary intervention of the left main coronary artery in a patient with extrinsic compression caused by massive pulmonary artery enlargement. J Thorac Cardiovasc Surg 2012; 144:1517-8. [DOI: 10.1016/j.jtcvs.2012.07.086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2012] [Accepted: 07/30/2012] [Indexed: 10/28/2022]
|
16
|
Goda M, Budts W, Troost E, Meyns B. Bicuspid pulmonary valve with atrial septal defect leading to pulmonary aneurysm. Ann Thorac Surg 2012; 93:1706-8. [PMID: 22541203 DOI: 10.1016/j.athoracsur.2011.09.063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2011] [Revised: 09/09/2011] [Accepted: 09/23/2011] [Indexed: 11/19/2022]
Abstract
Pulmonary artery aneurysms are rare. We describe 2 adult patients with pulmonary artery aneurysm with normal pulmonary pressure associated with bicuspid pulmonary valve and atrial septal defect. One patient presented with moderate pulmonary valve stenosis and was treated with open surgery; the other patient had a small atrial septal defect and mild pulmonary valve insufficiency and is periodically still being evaluated. Hemodynamic alterations associated with a pulmonary artery aneurysm are described; the influence of additional volume overload and intrinsic wall abnormalities in pulmonary valvular lesions as potential triggers for the development of these aneurysms are analyzed and therapeutic strategies are discussed.
Collapse
Affiliation(s)
- Motohiko Goda
- Department of Cardiac Surgery, University Hospital Leuven, Leuven, Belgium.
| | | | | | | |
Collapse
|
17
|
Bagur R, Gleeton O, Bataille Y, Bilodeau S, Rodés-Cabau J, Bertrand OF. Right coronary artery from the left sinus of valsalva: Multislice CT and transradial PCI. World J Cardiol 2011; 3:54-6. [PMID: 21390197 PMCID: PMC3051149 DOI: 10.4330/wjc.v3.i2.54] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2010] [Revised: 01/21/2011] [Accepted: 01/27/2011] [Indexed: 02/06/2023] Open
Abstract
A 42-year-old-woman presented with de novo crescendo angina. Thallium-scintigraphy showed inferior ischemia. Coronary angiogram revealed a right coronary artery (RCA), originating from the left sinus of Valsalva with a severe proximal systolic compression. She underwent successful transradial percutaneous coronary intervention with stent implantation. Multislice-computed tomography (MSCT) is usually used to evaluate coronary artery anomalies and can effectively show the anomalous RCA and the inter-arterial trajectory between the aorta and pulmonary arteries. Anomalies of the origin of the coronary arteries are rare, but can produce specific clinicopathological entities that should be diagnosed with accuracy. This case report illustrates the role of MSCT in the detailed description of an abnormal coronary artery and the use of stenting for symptoms relief.
Collapse
Affiliation(s)
- Rodrigo Bagur
- Rodrigo Bagur, Onil Gleeton, Yoann Bataille, Sylvie Bilodeau, Josep Rodés-Cabau, Olivier F Bertrand, Interventional Cardiology Laboratories, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec G1V4G5, Canada
| | | | | | | | | | | |
Collapse
|
18
|
Mehanna EA, Attizzani GF, Kyono H, Hake M, Bezerra HG. Assessment of coronary stent by optical coherence tomography, methodology and definitions. Int J Cardiovasc Imaging 2011; 27:259-69. [PMID: 21336555 DOI: 10.1007/s10554-010-9793-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2010] [Accepted: 12/30/2010] [Indexed: 10/18/2022]
Abstract
Optical coherence tomography has emerged as a powerful tool for stent assessment, and in a short time, has become the modality of choice for studying stent and vascular interactions in vivo. In this review, we discuss qualitative and quantitative parameters used for stent assessment by OCT. Various qualitative/quantitative variables of stent assessment are discussed in the perspective of the clinical and research values of each of them.
Collapse
Affiliation(s)
- Emile Aziz Mehanna
- Harrington-McLaughlin Heart and Vascular Institute, University Hospitals Case Medical Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | | | | | | |
Collapse
|
19
|
Neema PK, Dharan BS, Singha S, Sethuraman M, Chandran DA, Rathod RC. Anesthetic implications of aneurysmal main pulmonary artery and left pulmonary artery and right pulmonary artery stenosis in a child undergoing main pulmonary artery and right pulmonary artery plasty and atrial septal defect closure. J Cardiothorac Vasc Anesth 2011; 26:280-2. [PMID: 21292504 DOI: 10.1053/j.jvca.2010.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2010] [Indexed: 11/11/2022]
Affiliation(s)
- Praveen Kumar Neema
- Department of Anaesthesiology and Cardiothoracic and Vascular Surgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
| | | | | | | | | | | |
Collapse
|
20
|
Koppara T, Mehilli J, Hager A, Kaemmerer H. Left main coronary artery compression in a young woman with Eisenmenger syndrome. HEART ASIA 2011; 3:13-5. [PMID: 27325973 DOI: 10.1136/ha.2009.001578] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
|
21
|
Lee MS, Oyama J, Bhatia R, Kim YH, Park SJ. Left main coronary artery compression from pulmonary artery enlargement due to pulmonary hypertension: A contemporary review and argument for percutaneous revascularization. Catheter Cardiovasc Interv 2010; 76:543-50. [DOI: 10.1002/ccd.22592] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
22
|
Vaseghi M, Lee MS, Currier J, Tobis J, Shapiro S, Aboulhosn J. Percutaneous intervention of left main coronary artery compression by pulmonary artery aneurysm. Catheter Cardiovasc Interv 2010; 76:352-6. [DOI: 10.1002/ccd.22555] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|