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Left main coronary artery compression by dilated main pulmonary artery in atrial septal defect
S S Kothari1, S S Chatterjee, S Sharma
1Cardiothoracic Centre, All India Institute of Medical Sciences, New Delhi.
Insights
Left main coronary artery compression is rare in atrial septal defect patients. This study found no specific clinical or hemodynamic factors predicting this rare complication in patients with atrial septal defect.
Area of Science:
- Cardiology
- Cardiovascular Surgery
Background:
- Dilated pulmonary artery can compress the left main coronary artery in patients with atrial septal defect (ASD).
- This phenomenon is not well-characterized, necessitating further investigation.
Purpose of the Study:
- To retrospectively analyze the occurrence and characteristics of left main coronary artery compression in patients with ASD.
Main Methods:
- Retrospective review of data from 41 patients with ASD who underwent selective coronary angiography.
- Analysis of patient demographics, pulmonary artery pressure, shunt ratio, and coronary angiogram findings.
Main Results:
- Left main coronary artery ostial stenosis was identified in 2 patients (4.8%).
- No clinical or hemodynamic parameters differentiated patients with or without coronary changes.
- Two patients (4.8%) had coexistent atherosclerotic coronary artery disease.
Conclusions:
- Left main coronary trunk compression is a rare complication in patients with atrial septal defect.
- The findings are relevant for the clinical evaluation of patients with ASD, particularly regarding potential coronary artery issues.
Abstract:
Left main coronary artery compression by dilated pulmonary artery in patients with atrial septal defect has previously been reported, but not well characterized. Accordingly, we review retrospectively data of patients with atrial septal defect in whom selective coronary angiograms were done. 41 patients (26 females), aged 47.3 +/- 7.4 years were studied. The pulmonary artery mean pressure was 22.7 +/- 8.3 mm Hg and all patients had left to right shunt ratio of 2:1 or more (mean ratio: 3.9 +/- 1.7). Two patients (4.8%) had left coronary ostial stenosis. There were no clinical or haemodynamic parameters to differentiate the patients with or without these changes. Two patients (4.8%) had coexistent atherosclerotic coronary artery disease. In conclusion, left main coronary trunk compression rarely occurs in patients with atrial septal defect. This information may be relevant in evaluating patients with atrial septal defect.