Lecompte maneuver for compressed left coronary artery after pulmonary artery banding

Area of Science:

• Cardiology
• Pediatric Cardiac Surgery
• Congenital Heart Disease

Background:

• Complete atrioventricular septal defect is a complex congenital heart condition.
• Pulmonary artery banding is a palliative surgical procedure for certain heart defects.
• High take-off of the coronary artery is a rare anomaly that can be associated with congenital heart disease.

Purpose of the Study:

• To report a case of a neonate with complete atrioventricular septal defect and an undiagnosed high take-off left coronary artery.
• To describe the management of severe heart failure caused by compression of the coronary artery after pulmonary artery banding.
• To highlight the effectiveness of the Lecompte maneuver in treating this specific complex congenital heart anomaly.

Main Methods:

• A one-month-old infant with complete atrioventricular septal defect underwent pulmonary artery banding.
• A high take-off of the left coronary artery was identified postoperatively, compressed by the dilated right pulmonary artery.
• The patient was treated with a Lecompte maneuver for severe heart failure.

Main Results:

• The Lecompte maneuver effectively relieved the compression of the high take-off left coronary artery.
• Post-procedural recovery indicated successful treatment of the severe heart failure.
• This case demonstrates the importance of considering coronary artery anomalies in complex pediatric cardiac surgery.

Conclusions:

• The Lecompte maneuver is an effective surgical option for managing heart failure secondary to coronary artery compression in neonates with congenital heart defects.
• Undiagnosed coronary artery anomalies, such as a high take-off, can lead to critical complications after palliative cardiac surgery.
• Early identification and appropriate surgical correction are crucial for favorable outcomes in complex pediatric congenital heart disease.