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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat
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Left Atrial Stenosis Induced Pulmonary Venous Arterialization and Group 2 Pulmonary Hypertension in Rat

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Emergency trans-catheter coronary intervention for left main compression secondary to pulmonary hypertension in a

Gianfranco Butera1, Nizar Ben Mansour1, Federico De Marco1

  • 1Department of Congenital Cardiology and Cardiac Surgery, IRCCS Policlinico San Donato, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 10, 2018
PubMed

Insights

A child with severe heart defects experienced ischemic cardiomyopathy due to pulmonary artery compression. A rescue angioplasty successfully treated the blocked coronary artery bypass, improving blood flow.

Area of Science:

  • Pediatric Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • A 4-year-old child presented with a large atrial septal defect (ASD) and severe pulmonary hypertension.
  • The patient developed ischemic cardiomyopathy, likely caused by left main (LM) coronary artery compression from a dilated pulmonary artery trunk.

Observation:

  • Surgical repair of ASD and coronary artery bypass grafting (CABG) did not allow for ECMO weaning.
  • Coronary angiography revealed near-occlusion of the left internal mammary artery bypass graft.

Findings:

  • A rescue percutaneous intervention was performed on the left main coronary artery.
  • Successful implantation of a drug-eluting stent restored LM artery patency.

Implications:

  • Percutaneous coronary intervention can be a viable rescue strategy for complex pediatric coronary artery issues.
  • This case highlights the challenges in managing severe pulmonary hypertension-related cardiac complications in children.

Keywords:
angioplastyatrial septal defectleft main coronary arterypulmonary arterial hypertensionstent

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