Coronary arterial compression treated by stenting after replacement of the mitral valve in a child
Mervat A Assaqqat1, Walid Hassan, Ghassan Siblini
1Department of Cardiovascular Diseases, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Insights
A nine-year-old girl with Shone's syndrome experienced myocardial ischemia after valve surgery. A stent successfully treated circumflex artery compression caused by a mechanical prosthesis.
Area of Science:
- Cardiology
- Pediatric Cardiology
- Interventional Cardiology
Background:
- Shone's syndrome is a rare congenital heart defect.
- The patient had a history of aortic coarctation treated in infancy.
Observation:
- The patient developed severe sub-aortic stenosis and moderate mitral valvar stenosis.
- Mitral valve replacement with a mechanical prosthesis and sub-aortic shelf resection were performed.
Findings:
- Post-operative myocardial ischemia was observed.
- Coronary angiography revealed mechanical prosthesis compression of the circumflex artery.
- Successful balloon angioplasty and stenting of the circumflex artery were performed.
Implications:
- This case highlights a rare complication of mechanical valve prosthesis in pediatric Shone's syndrome.
- Interventional cardiology techniques can effectively manage prosthesis-induced coronary artery compression.
- Timely diagnosis and intervention are crucial for favorable outcomes in complex congenital heart disease.
Abstract:
We describe the clinical history of a nine years old girl with Shone's syndrome. She underwent balloon angioplasty of the aortic coarctation in infancy, and later developed severe sub-aortic stenosis and moderate mitral valvar stenosis. The mitral valve was therefore replaced with a mechanical prosthesis, and the sub-aortic shelf was resected. Immediately after the operation, she developed signs of myocardial ischemia. Coronary angiography showed compression of the middle part of the circumflex artery by the mechanical prosthesis, the obstructed segment being successfully dilated using a coronary arterial stent.
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