Complete obstruction of the left main coronary artery associated with congenital pulmonary valvular stenosis

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Congenital Heart Disease

Background:

• Left main coronary artery (LMCA) obstruction presents a grave prognosis without surgical intervention.
• Aortocoronary saphenous vein bypass is the standard surgical approach for LMCA obstruction.
• Congenital pulmonary valvular stenosis is a distinct cardiac anomaly.

Observation:

• This report details a rare case of concurrent atherosclerotic LMCA obstruction and congenital pulmonary valvular stenosis.
• The patient presented with this unusual combination of cardiovascular pathologies.
• Surgical intervention involved both aortocoronary saphenous vein bypass and pulmonary valvotomy.

Findings:

• The patient underwent successful aortocoronary saphenous vein bypass grafting to the left coronary artery system.
• Simultaneously, a pulmonary valvotomy was performed to address the congenital stenosis.
• Post-operative follow-up at 22 months revealed the patient remained asymptomatic.

Implications:

• This case demonstrates the feasibility and positive outcomes of combined surgical procedures for complex coronary and valvular heart disease.
• It expands the documented clinical presentations of congenital pulmonary valvular stenosis co-existing with coronary artery disease.
• The findings support aggressive surgical management for severe LMCA obstruction, even in the presence of other congenital cardiac defects.