PMC2800011_01
(A) Antero-posterior view of coronary angiography showing compression of the mid-left anterior descending artery (arrow). (B) Right antero-oblique view of coronary angiography showing stenosis of the proximal left circumflex artery (arrow).
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F1
A coronary angiogram was performed, which demonstrated 95% stenosis of the middle left anterior descending coronary artery (LAD), 95% stenosis of the proximal left circumflex artery (LCX), and 90% stenosis of the right coronary artery (Fig. 1).
Schematic drawing depicting the intra-operative findings. As the heart herniated into the left pleural cavity, it was strangulated by the margins of the remaining pericardium, resulting in a bridle stricture of both the right and left margins of the heart, with subsequent narrowing of the ventricle in this area
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F2
The heart was tethered in place by adhesions along its anterior surface (Fig. 2).