Left Main Coronary Artery Compression following Melody Pulmo
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Case Report
A 30-year-old woman with prior Ross procedure for subaortic stenosis, presented with moderate to severe pulmonary homograft stenosis/regurgitation and New York Heart Association class II symptoms. Due to four prior sternotomies, she was considered high surgical risk and the decision was made to proceed with percutaneous transvenous transcatheter pulmonary valve replacement (Melody valve (Medtronic Inc., Minneapolis, MN, USA)) in the catheterization laboratory. After initial balloon inflation, there was visible homograft enlargement, and simultaneous aortic root angiogram was performed demonstrating patent right and left coronary arteries (LCA). The right ventricular outflow tract was then prepared with successful placement of two Palmaz stents. Repeat coronary angiography demonstrated patent LCA prior to Melody valve deployment. The Melody valve was then deployed and the patient developed progressive, severe hypotension, bradycardia, and cardiogenic shock. Transthoracic echocardiogram (TTE) demonstrated akinesis of the lateral and anterior walls of the left ventricle (LV) and severe acute mitral valve regurgitation. She instantly developed severe pulmonary edema with fluid filling the endotracheal tube and anesthesia circuit.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4006580/
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