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Surgical Treatment of Pulmonary Artery Aneurysm with Coronary Artery Compression

A 47-year-old female presented with exertional dyspnea and chest pain. A transthoracic echocardiogram (TTE) revealed pulmonary artery stenosis with a mean gradient of 29mmHg and an aneurysmal pulmonary artery (PA). A chest computed tomography (CT) revealed an aneurysm of the main PA trunk measuring 6.5 cm, which compressed the left main and left anterior descending artery (LAD; Fig. 1A). The patientwas placed on cardiopulmonary bypass and after antegrade cardioplegic arrest, a longitudinal incision was made in the main PA revealing thickened pulmonary valve leaflets with fusion of all three commissures (Fig. 2). A commissurotomy was performed and the excess PA was resected for a width of 1 cm and closed with a 5– 0 prolene suture. The patient tolerated the procedure well. A postoperative CT angiogram showed a