Huge left coronary artery aneurysm associated with multiple arterial aneurysms

Coronary artery aneurysm combined with other multiple aneurysms at multiple locations: A case report and systematic review

BACKGROUND

Coronary artery aneurysm (CAA) with concomitant aneurysms at multiple sites is quite unusual and rare. The characteristics and the etiology of this phenomenon are unknown.

METHODS

Herein, we present a case with right coronary aneurysm with concomitant abdominal aorta as well as right renal artery aneurysm. A systematic review of the literatures regarding CAA with other coexisting aneurysms at multiple locations was also conducted on Medline and Embase databases.

RESULTS

A total of 76 patients (male gender: 58; age: 37.4 ± 26.5) including the present case were included in the final study. The most common etiology of CAA with multiple aneurysms was Kawasaki (43.3%) and atherosclerotic disease (16.4%). CAA was the most frequently found at the right coronary artery (62.7%), following, left anterior descending (51%), left main (43.1%), and left circumflex (35.3%). The most common concomitant aneurysms were abdominal aorta (52.6%) and iliac artery (50%). In addition, 60.5% of the patients had an involved bilateral peripheral artery.

CONCLUSION

CAA with coexisting systemic aneurysms in multiple sites is quite rare. And it usually involves multiple aneurysms at the coronary and bilateral peripheral arteries simultaneously. Currently, there are no general consensus regarding the clinical characteristics, diagnostic method, and treatment of these cases.

Combined surgical approach to multiple giant coronary artery aneurysms

Multiple giant coronary artery aneurysms are rare but can develop in the presence of an underlying atherosclerotic vessel disease. Nevertheless, there is no consensus on the ideal surgical treatment or on operative procedures, including aneurysm resection, ligation, distal bypass, and graft interposition. We present the case of a 72-year-old woman with a history of multiple arterial aneurysms who was admitted to the emergency clinic with sudden-onset chest pain and dyspnea. The patient's diagnosis was ischemic heart disease and multiple giant coronary artery aneurysms involving the left anterior descending coronary artery and the proximal and distal segments of the right coronary artery. We present a combined surgical approach to multiple giant coronary artery aneurysms associated with atherosclerosis.

Preoperative and postoperative evaluation of multiple giant coronary aneurysms by the use of coronary CT angiography with 64-MDCT: a case of multiple giant coronary aneurysms treated with aneurysmectomy and coronary artery bypass surgery

A coronary artery aneurysm is an uncommon disorder and is seen as a characteristic dilatation of a localized portion of the coronary artery. Clinical manifestation of a coronary artery aneurysm varies from an asymptomatic presentation to sudden death of a patient. Although coronary aneurysms are typically diagnosed by the use of coronary angiography, a new generation of coronary 64-slice multidetector computed tomography (64-MDCT) scanners have successfully been used for evaluating this abnormality in a noninvasive manner. In the present case, we performed coronary 64-MDCT scanning preoperatively and postoperatively on a patient with multiple giant coronary aneurysms. The use of coronary 64-MDCT may provide an evaluation technique not only for diagnosis but also for follow-up after surgery for this condition.

Coronary artery aneurysms: an unusual case report and a review of the literature

Coronary artery aneurysms (CAA) were first recognized in postmortem studies. More recently they have been recognized in antemortem and angiographic studies and are reported to occur at an incidence of 1-2%. Left main coronary aneurysms (LMCA) are extremely rare with an incidence of 0.1%. Most of the aneurysms discovered in these angiographic studies have been in patients with cardiac symptoms of angina or acute myocardial infarction who subsequently were found to have severe narrowing of the coronary arteries. Angiographic and clinical data of a patient with a large aneurysm of the left main coronary artery and with aneurysmal disease of the thoracic and abdominal aorta are presented along with a review of the literature.