title: Left Main Coronary Artery Stenting to Relieve Extrinsic Compression by a Giant Pulmonary Artery Aneurysm in a Patient with Idiopathic Pulmonary Artery Hypertension.
abstract: Pulmonary artery aneurysm (PAA) is a rare but lethal disease. We present a female patient with idiopathic pulmonary artery hypertension (IPAH)-related PAA, who suffered from unstable angina pectoris. Multi-detector computed tomography and coronary angiogram revealed extrinsic compression of the left main coronary artery (LMCA) caused by a giant PAA with severe ostial stenosis. Intravascular ultrasound showed an oval-shaped ostium of the LMCA, indicating extrinsic compression. After successful LMCA stent implantation, chest pain was greatly relieved. This case illustrates that beyond right ventricle ischaemia and coronary atherosclerotic disease, LMCA compression by PAA should be considered in the differential diagnosis of angina in patients with IPAH related PAA. In addition, intravascular ultrasound can be used to confirm the diagnosis and guide the stent implantation safely.
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Hung-Chih
authors.initials: HC
authors.lastname: Pan
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming University, Taipei, Taiwan; Department of Medicine, China Medical University, Taichung, Taiwan; Department of Medicine, Chung Shan Medical University, Taichung, Taiwan. Electronic address: wky830@gmail.com.
authors.forename: Kuo-Yang
authors.initials: KY
authors.lastname: Wang
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Cardiovascular Research Center, School of Medicine, National Yang Ming University, Taipei, Taiwan. Electronic address: ekwliang@gmail.com.
authors.forename: Kae-Woei
authors.initials: KW
authors.lastname: Liang
mesh_terms: D000783:Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D008875:Middle Aged; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D015607:Stents; D014057:Tomography, X-Ray Computed
keywords: Idiopathic pulmonary artery hypertension (IPAH); Intravascular ultrasound (IVUS); Left main coronary artery (LMCA); Pulmonary artery aneurysm (PAA); Stent