Emergency trans-catheter coronary intervention for left main compression secondary to pulmonary hypertension in a 4-year-old child

Here, we report on the case of a 4-year-old child with large atrial septal defect (ASD) and severe pulmonary hypertension presenting an ischemic cardiomyopathy secondary to left main (LM) compression by a dilated pulmonary artery trunk. Despite of surgical treatment consisting in ASD closure and coronary artery bypass grafting, the patient was not weanable from ECMO. Control coronarography showed a near-occlusion of the left mammary bypass. A rescue percutaneous LM angioplasty with drug-eluting stent implantation was performed.