“Treat-Repair-Treat”:Management of Left Main Coronary Compression by a Pulmonary Artery Aneurysm in a Patient with Atrial Septal Defect and Significant Pulmonary Hypertension

作     者：Andrei George Iosifescu Roxana Enache Ioana Marinică Corina Radu Vlad Anton Iliescu 

作者机构：Carol Davila University of Medicine and PharmacyBucharest020021Romania Department of Cardiac SurgeryC.C.Iliescu Emergency Institute for Cardiovascular DiseasesBucharest022322Romania Department of CardiologyC.C.Iliescu Emergency Institute for Cardiovascular DiseasesBucharest022322Romania Department of Cardiovascular Anesthesia and Intensive CareC.C.Iliescu Emergency Institute for Cardiovascular DiseasesBucharest022322Romania 

出 版 物：《Congenital Heart Disease》 (先天性心脏病（英文）)

年 卷 期：2023年第18卷第1期

页      面：67-72页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 1010[医学-医学技术（可授医学、理学学位）] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 0703[理学-化学] 0702[理学-物理学] 1009[医学-特种医学] 10[医学] 

主　　题：Atrial septal defect pulmonary arterial hypertension pulmonary artery aneurysm left main coronary compression syndrome surgery unidirectional valved patch 

摘      要：Left main coronary compression syndrome(LMCS)may complicate pulmonary artery aneurysms(PAA),usually developed in the context of pulmonary arterial hypertension(PAH).We report the case of a 51-year-old female patient with an atrial septal defect(unsuitable for device closure)complicated by a PAA generating a 90%left main *** significant PAH held us back from immediate *** specific dual PAH-targeted therapy(sildenafil and bosentan),the atrial septal defect could be closed with a unidirectional valved patch;the PAAinduced LMCS was treated by reductive *** postoperative course was ***-up showed clinical improvement,but PAH treatment was still *** three months,coronary angiography showed only an insignificant residual left main stenosis,proving that reductive pulmonary arterioplasty was effective in treating *** PAA requires further evaluation for LMCS,a dangerous but treatable ***“treat-repair-treatstrategy and shunt-closure with a unidirectional valved patch can both improve surgical prospects of LMCS with shunt-related PAH.