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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Acute coronary syndrome caused by left main coronary artery compression between the aortic root and massive dilation

Bin Wang1, Yan Wang1

  • 1Department of Cardiology, Xiamen Heart Center, Xiamen University, Xiamen, People's Republic of China.

The Canadian Journal of Cardiology
|February 10, 2015
PubMed

Insights

Pulmonary artery dilation can compress the left main artery, mimicking stenosis. This case highlights an enlarged left atrium causing external compression, successfully treated with stenting.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Left main coronary artery compression is a rare condition.
  • Common causes include pulmonary artery dilation.
  • Treatment options include percutaneous coronary intervention (PCI) or surgery.

Observation:

  • A 78-year-old male presented with exertional chest pain and dyspnea.
  • Coronary angiography showed ostial left main artery stenosis.
  • Intravascular ultrasound revealed external compression, not atherosclerotic plaque.

Findings:

  • 64-slice multidetector coronary computed tomography identified an enlarged left atrium as the source of compression.
  • The patient underwent successful stenting of the left main artery lesion.
  • The patient remained asymptomatic with no signs of coronary insufficiency at 18-month follow-up.

Implications:

  • This case expands the differential diagnosis of left main artery compression.
  • It underscores the utility of advanced imaging in identifying non-atherosclerotic causes.
  • Successful stenting offers a viable treatment option for left main compression by an enlarged left atrium.

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