Case report
Left Main Coronary Artery Compression Long Term After Repair of Conotruncal Lesions: The Bow String Conduit

https://doi.org/10.1016/j.athoracsur.2011.12.048Get rights and content

We report 4 cases of left main coronary artery (LMCA) compression after remote repair of conotruncal lesions and their successful surgical management.

Section snippets

Patient 1

A 26-year-old woman with d-TGA and VSD underwent arterial switch and VSD closure at 1 year of age. At the time, a Lecompte maneuver was not performed and a Polystan conduit (20 mm) (Polystan A/S, Hovedstaden, Denmark) recreated the neo–main pulmonary artery. The patient presented with angina, dyspnea, and exertional syncope. Cardiac computed tomography (CT) demonstrated LMCA compression by the calcified conduit. At operation, the LMCA was free of plaque and was enlarged to 7 mm with an

Comment

LMCA compression by the PAs has been described in patients presenting with pulmonary hypertension and may lead to sudden death [1]. It is also a known complication of endovascular right ventricular outflow tract procedures [1]. We report a case series of adult patients with congenital heart disease who presented with LMCA compression late after surgical repair of conotruncal lesions. Although unlikely to have been present at the time of the original operation, we speculate that the compression

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