Document Detail


Left main coronary artery compression from pulmonary artery enlargement due to pulmonary hypertension: a contemporary review and argument for percutaneous revascularization.
MedLine Citation:
PMID:  20506194     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Extrinsic compression of the left main coronary artery by an enlarged pulmonary artery is an increasingly recognized and potentially reversible cause of angina and left ventricular dysfunction in patients with pulmonary hypertension. The diagnosis of extrinsic left main coronary artery compression requires a high index of suspicion and should be considered in patients with severe pulmonary hypertension who experience angina. Coronary angiography with intravascular ultrasound is the gold standard for diagnosis of this condition, though cardiac computed tomography and magnetic resonance angiography allow for noninvasive means of screening. The optimal treatment is debatable, but percutaneous coronary intervention appears to be a feasible, safe, and effective treatment option for patients with extrinsic compression of the left main coronary artery from pulmonary artery enlargement. Given the high risk of postoperative right ventricular failure and mortality observed with surgical revascularization in these patients, we recommend that physicians recognize percutaneous coronary intervention as the preferred revascularization strategy for selected patients with extrinsic compression of the left main coronary artery due to pulmonary hypertension. © 2010 Wiley-Liss, Inc.
Authors:
Michael S Lee; Jared Oyama; Ravi Bhatia; Young-Hak Kim; Seung-Jung Park
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  76     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-30     Completed Date:  2011-01-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  543-50     Citation Subset:  IM    
Affiliation:
Division of Cardiology, David Geffen School of Medicine at University of California, Los Angeles, California 90095-171715, USA. mslee@mednet.ucla.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / etiology,  therapy
Angioplasty, Balloon, Coronary* / adverse effects,  instrumentation,  mortality
Coronary Stenosis / diagnosis,  etiology,  mortality,  therapy*
Diagnostic Imaging / methods
Female
Humans
Hypertension, Pulmonary / complications*,  mortality,  pathology
Middle Aged
Pulmonary Artery / pathology*
Risk Assessment
Risk Factors
Stents
Treatment Outcome
Ventricular Dysfunction, Left / etiology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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