Caldera Angel E, Cruz-Gonzalez Ignacio, Bezerra Hiram G, Cury Ricardo C, Palacios Igor F, Cockrill Barbara A, Inglessis-Azuaje Ignacio
Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Massachusetts General Hospital, Harvard Medical School, Boston, MA.
Chest. 2009 Jun;135(6):1648-1650. doi: 10.1378/chest.08-2922.
Extrinsic compression of the left main coronary artery (LMCA) can occur in patients with severe pulmonary hypertension and enlarged pulmonary artery trunk. It has been usually described in the setting of congenital defects such as atrial septal defect, ventricular septal defect, and, more rarely, isolated persistent ductus arteriosus. Functional and structural evaluation of such patients can currently be performed noninvasively with the use of cardiac CT scanning and/or MRI. The optimal management of symptomatic patients remains unknown. We report a case of extrinsic compression of the LMCA in a symptomatic patient with Eisenmenger syndrome who underwent unprotected LMCA stent implantation. We also performed a literature review of the reported cases concerning patients treated with LMCA stent implantation for the management of this condition.
左冠状动脉主干（LMCA）的外在压迫可发生于严重肺动脉高压和肺动脉主干扩大的患者。通常在先天性缺陷的情况下出现，如房间隔缺损、室间隔缺损，更罕见的是孤立性动脉导管未闭。目前可通过心脏CT扫描和/或MRI对这类患者进行无创的功能和结构评估。有症状患者的最佳治疗方案仍不明确。我们报告1例患有艾森曼格综合征的有症状患者出现LMCA外在压迫，该患者接受了无保护的LMCA支架植入术。我们还对已报道的关于采用LMCA支架植入术治疗此疾病的患者病例进行了文献综述。
