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  • Title: Extrinsic compression of the left coronary ostium by the pulmonary trunk: management in a case of Eisenmenger syndrome.
    Author: Sivakumar K, Rajan M, Francis G, Murali K, Bashi V.
    Journal: Tex Heart Inst J; 2010; 37(1):95-8. PubMed ID: 20200637.
    Abstract:
    Extrinsic compression of the left main coronary artery by a massively dilated pulmonary artery in patients who have severe pulmonary hypertension can lead to significant myocardial ischemia. A 58-year-old man with a large patent ductus arteriosus and Eisenmenger syndrome presented with angina at rest and worsening heart failure of 3 months' duration. The new symptoms were recognized to be secondary to extrinsic compression of the left main coronary artery ostium by a dilated main pulmonary artery and were successfully relieved by the placement of a metallic stent in the affected segment of the left main coronary artery. Multislice computed tomographic imaging after 6 months showed stent patency and the intimate relation of the stented vessel to the dilated main pulmonary trunk. We discuss diagnostic and management issues pertaining to this uncommon clinical entity.
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