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Ann Thorac Surg 2008;86:1987-1989. doi:10.1016/j.athoracsur.2008.05.046
© 2008 The Society of Thoracic Surgeons
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Case Reports

Extrinsic Compression of the Left Main Coronary Artery by Atrial Septal Defect

Yusuke Jo, MDa, Akio Kawamura, MDa,*, Masahiro Jinzaki, MDb, Takashi Kohno, MDa, Toshihisa Anzai, MDa, Shiro Iwanaga, MDa, Kiyokazu Kokaji, MDc, Tsutomu Yoshikawa, MDa, Ryohei Yozu, MDc, Sachio Kuribayashi, MDb, Satoshi Ogawa, MDa

a Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
b Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan
c Department of Radiology, Keio University School of Medicine, Tokyo, Japan

Accepted for publication May 15, 2008.

* Address correspondence to Dr Kawamura, Division of Cardiology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan (Email: kawamura{at}cpnet.med.keio.ac.jp).

On rare occasions, extrinsic compression of the coronary artery can cause significant stenosis. We report a 42-year-old woman who was referred to our hospital for surgical repair of atrial septal defect. Cardiac 64-slice multi-detector computed tomography before the operation revealed the extrinsic compression of the proximal left main coronary artery by the marked dilatation of pulmonary trunk. The patient eventually underwent atrial septal defect closure and coronary artery bypass simultaneously. Four months after the operation, multi-detector computed tomographic scan revealed reduction of pulmonary trunk diameter and resolution of left main coronary artery narrowing.






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