1
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Toda K, Takagi K, Noguchi T. Silent rapid progression of mycotic left main aneurysm following stenting to bailout for acute occlusion caused by infective endocarditis. Eur Heart J 2023; 44:3932. [PMID: 37351862 DOI: 10.1093/eurheartj/ehad399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2023] Open
Affiliation(s)
- Kojiro Toda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, S1W17 Chuoh-ku, Sapporo, Hokkaido 060-8556, Japan
| | - Kensuke Takagi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
- Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1 Chome-1-1 Honjo, Chuo Ward, Kumamoto 860-8556, Japan
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2
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Suenaga A, Tazaki J, Tatsushima S, Fujita T, Hara N, Tsuji S, Iseda T, Kimura T, Shibamori Y, Nomura S, Yoshida A, Hatamura M, Sakamoto R, Hirao S, Kanemitsu N, Toyofuku M. Ruptured mycotic coronary artery aneurysm hybrid treatment with covered stent and surgical debridement. J Cardiol Cases 2023; 28:144-146. [PMID: 37818433 PMCID: PMC10562108 DOI: 10.1016/j.jccase.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/08/2023] [Accepted: 05/12/2023] [Indexed: 10/12/2023] Open
Abstract
We present a case of a ruptured mycotic coronary aneurysm effectively treated with covered stents and phased surgery. The covered stent, however, became occluded two years later. Because of the low invasiveness, a covered stent treatment may be advantageous over conventional surgery but trade off long-term vascular patency. Learning objective To recognize the presence of a ruptured infectious coronary aneurysm after a primary coronary stenting for ST-elevation myocardial infarction.To discuss the treatment strategies for a ruptured infectious coronary aneurysm with a covered stent.
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Affiliation(s)
- Akihira Suenaga
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Junichi Tazaki
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Shojiro Tatsushima
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Takanari Fujita
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Noriko Hara
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Shuhei Tsuji
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Takahiro Iseda
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Tomoya Kimura
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Yuichiro Shibamori
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Shinnosuke Nomura
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Akinori Yoshida
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Miyu Hatamura
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Ryo Sakamoto
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Shingo Hirao
- Department of Cardiovascular Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Naoki Kanemitsu
- Department of Cardiovascular Surgery, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
| | - Mamoru Toyofuku
- Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama City, Japan
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3
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Niccum M, Gupta M, Rome JJ, O'Byrne ML. Coil Embolization of a Ruptured Mycotic Coronary Artery Aneurysm in a Pediatric Patient. JACC Case Rep 2023; 21:101967. [PMID: 37719297 PMCID: PMC10500331 DOI: 10.1016/j.jaccas.2023.101967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/12/2023] [Accepted: 07/11/2023] [Indexed: 09/19/2023]
Abstract
Mycotic coronary artery aneurysms are rare but have a high risk of mortality. Traditional management is surgical, but percutaneous intervention can be performed in patients with high surgical risk. In this report, we describe a case of mycotic coronary aneurysm in a pediatric patient successfully managed with percutaneous coil embolization. (Level of Difficulty: Advanced.).
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Affiliation(s)
- Maria Niccum
- Division of Cardiology, The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mudit Gupta
- Division of Cardiology, The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Jonathan J. Rome
- Division of Cardiology, The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael L. O'Byrne
- Division of Cardiology, The Children's Hospital of Philadelphia, and Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Cardiovascular Outcomes, Quality, and Evaluative Research Center and Leonard Davis Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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4
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Hali R, Sharifkazemi M, Yaminisharif A, Bagheri J, Shahbazi N. Coronary artery mycotic aneurysm in a patient suffering from subacute endocarditis: a case report and literature review. Front Cardiovasc Med 2023; 10:1188946. [PMID: 37600033 PMCID: PMC10435280 DOI: 10.3389/fcvm.2023.1188946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/13/2023] [Indexed: 08/22/2023] Open
Abstract
Although mycotic aneurysm is a known and important disease in the cerebrovascular system, especially the brain, there are scarce reports about coronary artery mycotic aneurysms (CAMA). CAMA can occur not only in the context of endocarditis but also as a rare adverse event of coronary artery stenting, which has been used more extensively in recent years. Accordingly, it is essential to pay greater attention to its associated presentations and clinical course. Considering the scant evidence available, reporting the disease course of each patient with CAMA can help increase the physician's knowledge about this condition, which is why we are reporting this case. A 42-year-old man with diabetes was referred to our center with embolic left cerebellar infarction 3 months earlier, as well as a 2-month history of feverishness before his referral. His blood culture was positive for Viridans Streptococci, and he had paraclinical signs of inflammation and two- and three-dimensional transthoracic and transesophageal echocardiography (2D & 3D TTE and TEE) signs of aortic and mitral valves' infective endocarditis with the destruction of the aortic valve, severe aortic and mitral regurgitation, severe pulmonary hypertension, and moderate biventricular systolic dysfunction. Regarding the obviously dilated left main coronary artery on TEE images, contrast-enhanced chest multidetector computed tomography was performed for better assessment of coronary arteries with suspicion of CAMA, which confirmed aneurysmal dilatation of the proximal left main coronary artery. The presence of bacteria was confirmed on staining the valvular tissue, resected during the surgical replacement of aortic and mitral valves. As the cardiac surgeon considered CAMA resection and coronary bypass grafting high risk for the patient, he received parenteral antibiotic therapy, for 6 weeks. At 1-year follow-up, he was doing well with no signs/symptoms of endocarditis and well-functioning mechanical prosthetic valves. This case shows the significance of considering CAMA in the setting of endocarditis, resistant to medical and/or surgical therapy or in patients with coronary aneurysm, simultaneous with active endocarditis. Therefore, more attention should be paid to this extravalvular complication of endocarditis, and its possibility should be considered and investigated in any patient presented with valvular endocarditis, especially involving the aortic valve.
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Affiliation(s)
- Reza Hali
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ahmad Yaminisharif
- Cardiology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Jamshid Bagheri
- Cardiovascular Surgery Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Narges Shahbazi
- Pathology Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
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5
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Fujioka K, Nishida Y, Higashi K, Eguchi Y, Fujita T, Uchiyama K, Fujimoto M. Rapid Formation of an Infected Coronary Artery Aneurysm With Stent Fracture. JACC Case Rep 2023; 6:101660. [PMID: 36704063 PMCID: PMC9871074 DOI: 10.1016/j.jaccas.2022.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/29/2022] [Indexed: 06/18/2023]
Abstract
Infected coronary artery aneurysm (ICAA) is a rare but fatal disease. We describe a case of rapid formation of ICAA with fracture of an intracoronary stent observed on coronary angiography and cardiac computed tomography. Surgery with resection of the aneurysm and coronary artery bypass grafting was performed successfully. (Level of Difficulty: Intermediate.).
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Affiliation(s)
- Kensuke Fujioka
- Department of Cardiovascular Medicine, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Yuji Nishida
- Department of Thoracic and Cardiovascular Surgery, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Keinosuke Higashi
- Department of General Medicine and Infectious Disease, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Yuya Eguchi
- Department of Cardiovascular Medicine, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Takashi Fujita
- Department of Cardiovascular Medicine, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Katsuharu Uchiyama
- Department of Cardiovascular Medicine, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Manabu Fujimoto
- Department of Cardiovascular Medicine, Kouseiren Takaoka Hospital, Takaoka, Japan
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6
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Price J, Okyere R, Al-Kindi S, Gupta A. Management of a right coronary artery mycotic coronary aneurysm with percutaneous intervention with covered stents. Catheter Cardiovasc Interv 2023; 101:108-112. [PMID: 36403280 DOI: 10.1002/ccd.30494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/19/2022] [Accepted: 11/08/2022] [Indexed: 11/21/2022]
Abstract
Coronary artery aneurysmal dilation is a rare finding with poorly understood mechanism of action that is found in small population of patients undergoing coronary angiography. Mycotic coronary aneurysm is an even rarer cause of coronary aneurysmal dilatation that develops as a potentially fatal complication of bacteremia. We present a case of mycotic right coronary artery aneurysm in a nonsurgical candidate with complex medical comorbidities treated with percutaneous coronary intervention via covered stents.
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Affiliation(s)
- Justin Price
- Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, Ohio, USA
| | - Robert Okyere
- Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, Ohio, USA
| | - Sadeer Al-Kindi
- Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
| | - Anjan Gupta
- Division of Cardiovascular Medicine, Harrington Heart and Vascular Institute, University Hospitals, Cleveland Medical Center, Cleveland, Ohio, USA.,Case Western Reserve University School of Medicine, Cleveland, Ohio, USA
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7
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Coronary Arteries Aneurysms: A Case-Based Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12102534. [PMID: 36292223 PMCID: PMC9600511 DOI: 10.3390/diagnostics12102534] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/17/2022] Open
Abstract
Coronary artery aneurysm (CAA) is an abnormal dilatation of a coronary artery segment; those coronary artery aneurysms that are very large in size are defined as giant. However, a standardized dimension cut-off to define giant CAAs is still missing. The reported prevalence of coronary aneurysms in the population who underwent coronary angiography ranges from 0.3% to 5%, and often CAAs are found in patient with aneurysms in other sites, such as the ascending or abdominal aorta. In half of the cases an atherosclerotic etiology could be recognized; often, CAA is found in the context of acute coronary syndrome. Seldomly, CAA is found at the autopsy of patients who died due to sudden cardiac death. Currently, very few data exist about CAA management and their prognostic relevance; moreover, CAA treatment is still not clearly codified, but rather case-based. Indeed, currently there are no published dedicated studies exploring the best medical therapy, i.e., with antiplatelets or anticoagulant agents rather than an interventional approach such as an endovascular or surgical technique. In this review, through two clinical cases, the current evidence regarding diagnostic tools and treatment options of CAAs will be described.
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8
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Kukkar V, Kapoor H, Aggarwal A. Mycotic and non-mycotic coronary artery aneurysms—A review of the rarity. J Clin Imaging Sci 2022; 12:13. [PMID: 35414960 PMCID: PMC8992365 DOI: 10.25259/jcis_218_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 02/24/2022] [Indexed: 11/17/2022] Open
Abstract
Sir William Osler coined the term “mycotic” to identify aneurysms secondary to an infectious cause, which may not be necessarily fungal and are caused mainly by bacteria. The literature’s reported incidence of coronary artery aneurysms (CAA) is from 1.5-5%. The right coronary artery (RCA) is mainly involved, followed by the left side coronary circulation. Mycotic aneurysms are more commonly associated with infective endocarditis. More recently, coronary artery stents, particularly drug-eluting stents, are typically causing mycotic coronary aneurysms. CT angiography (CTA) has been the forefront diagnostic modality, showing both the lumen and wall of the coronary arteries. It also aids in preoperative planning. MRI is useful in diagnosing and following children with Kawasaki’s disease. Smaller mycotic coronary aneurysms may resolve with antibiotic therapy; however, aneurysms more significant than 1-2 cm diameter needs corrective surgery. Early diagnosis and appropriate management are the critical factors in the successful treatment of infective coronary artery aneurysms.
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Affiliation(s)
- Vishal Kukkar
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, United States,
| | - Harit Kapoor
- Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, United States,
| | - Amit Aggarwal
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, United States,
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9
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Wareing T, Jogia P. Survival following non-operative management of infected coronary artery aneurysm with infected pericardial effusion complicated by multi-organ failure: a case report. Eur Heart J Case Rep 2022; 6:ytac079. [PMID: 35372759 PMCID: PMC8972825 DOI: 10.1093/ehjcr/ytac079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/19/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022]
Abstract
Background Infected coronary artery aneurysm with infected pericardial effusion is a very rare complication following percutaneous coronary intervention (PCI) and is associated with high mortality. Management options include open cardiothoracic surgery or non-operative management with pericardiocentesis. The best management option is currently unknown. Case summary A 76-year-old man with a background of hypertension, type two diabetes mellitus, chronic kidney disease, and a pacemaker presented with worsening shortness of breath 5 weeks following PCI to the right coronary artery (RCA) for a non-ST elevation myocardial infarction. His blood cultures grew methicillin-sensitive Staphylococcus aureus and he developed progressive renal failure and shortness of breath despite high-dose antibiotics. Echocardiography showed a pericardial effusion with impending tamponade and the patient proceeded urgently for pericardiocentesis. He subsequently developed severe cardiogenic and vasoplegic shock with multi-organ failure. Computed tomography coronary angiography (CTCA) showed an RCA aneurysm. He was conservatively managed with a pericardial window due to being too high risk for cardiac surgery and subsequently made a full recovery. Discussion Non-operative management of infected coronary artery aneurysm and infected pericardial effusion resulted in survival and return to baseline function in our patient despite the development of severe shock with multi-organ failure.
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Affiliation(s)
- Timothy Wareing
- Waikato Hospital, Intensive Care Unit, Pembroke Street, Hamilton 3204, New Zealand
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10
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Aneurisma micótico coronario complicado con seudoaneurisma ventricular izquierdo después de la implantación de stent de everolimus. Rev Esp Cardiol 2022. [DOI: 10.1016/j.recesp.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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11
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Diogo PG, Resende CX, Torres S, Vasconcelos M, Pinto R. Mycotic coronary aneurysm complicated by left ventricular pseudoaneurysm after everolimus-eluting stent implantation. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:275-277. [PMID: 34711515 DOI: 10.1016/j.rec.2021.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 09/17/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Pedro G Diogo
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal.
| | - Carlos X Resende
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Sofia Torres
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Mariana Vasconcelos
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
| | - Roberto Pinto
- Cardiology Department, Centro Hospitalar Universitário de São João, Porto, Portugal
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12
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Wadhokar P, Malani S, Patil R, Nalawade D. Mycotic coronary aneurysm: A rare complication of percutaneous coronary intervention. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.4103/jpcs.jpcs_26_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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13
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Greif S, Bernas M, Cogan J, Ghani OA. Case of Mycotic Coronary Aneurysm Treated with Percutaneous Coil Embolization. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2021; 80:291-294. [PMID: 34877540 PMCID: PMC8646862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Mycotic coronary aneurysms are rare, with potentially fatal complications. The treatment of choice is surgical intervention. We present a case of a mycotic coronary aneurysm secondary to a catheter-related bloodstream infection, failed surgical treatment, and eventual treatment with percutaneous coil embolization.
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Affiliation(s)
- Shana Greif
- Cardiovascular Disease Fellowship Program, John A. Burns School of Medicine, University of Hawai‘i (SG)
| | - Monika Bernas
- Internal Medicine Residency Program, John A. Burns School of Medicine, University of Hawai‘i (MB)
| | - John Cogan
- Interventional Cardiology, The Queen’s Medical Center, Honolulu, HI (JC)
| | - Omar Abdul Ghani
- Cardiovascular Disease, The Queen’s Medical Center, Honolulu, HI (AG)
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14
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Campos R, Yung G, Russo R, Mansberg R. Dissecting Mycotic RCA Aneurysm Detected on 67Ga Scintigraphy. Clin Nucl Med 2021; 46:822-825. [PMID: 34477602 DOI: 10.1097/rlu.0000000000003677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT A 61-year-old man presented with pneumonia and myocardial infarction on a background of diabetes and end-stage renal failure. Methicillin-resistant Staphylococcus aureus bacteremia was confirmed in the setting of ongoing pyrexia. The patient was referred for a 67Ga study, which revealed Ga-avid active disease in the pericardial effusion. This was localized further on CT/MRI and coronary angiography to a dissecting right coronary artery aneurysm, which was treated with surgical repair and long-term antibiotic treatment.
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Affiliation(s)
- Rossana Campos
- From the Department of Nuclear Medicine, Concord Hospital, Concord
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15
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Mansour MJ, Mansourati V, Richard M, Al Ayouby A, Mansourati J, Gilard M, Jobic Y. Multimodality Imaging of a Very Large Mycotic Aneurysm of the Right Coronary Artery. Circ Cardiovasc Imaging 2021; 14:e011327. [PMID: 33504159 DOI: 10.1161/circimaging.120.011327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Mohamad Jihad Mansour
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Division of Cardiology, Lebanese University, Faculty of Medical Sciences, Lebanon (M.J.M.)
| | - Vincent Mansourati
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
| | - Matthias Richard
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
| | - Ahmad Al Ayouby
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
| | - Jacques Mansourati
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
| | - Martine Gilard
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
| | - Yannick Jobic
- Department of Cardiology, University Hospital of Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.).,Université de Bretagne Occidentale, Brest, France (M.J.M., V.M., M.R., A.A.A., J.M., M.G., Y.J.)
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16
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Montgomery R, Javorski MJ, Bakaeen F, Tong MZ, Pettersson GB, Weiss AJ. Cardiogenic Shock From an Acute Rupture of an Infectious Saphenous Vein Graft Aneurysm. Ann Thorac Surg 2021; 111:e419-e420. [PMID: 33358888 DOI: 10.1016/j.athoracsur.2020.09.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 08/31/2020] [Accepted: 09/13/2020] [Indexed: 10/22/2022]
Abstract
Untreated infectious aneurysms of native coronary artery and aortocoronary bypass grafts are associated with high mortality. Early diagnosis proves difficult given nonspecific presenting symptoms; however, once recognized, early intervention is essential to mitigate complications such as myocardial ischemia or pericardial tamponade. In this case report, we describe the successful surgical management of a patient who presented 2 months after diagnosis of Staphylococcus aureus bacteremia with cardiogenic shock from rupture of an infected saphenous vein graft aneurysm resulting in pericardial tamponade.
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Affiliation(s)
- Robert Montgomery
- Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Michael J Javorski
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Faisal Bakaeen
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Michael Z Tong
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Gosta B Pettersson
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio
| | - Aaron J Weiss
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio.
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17
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Kato T, Takama N, Aihara K, Harada T, Obokata M, Kurabayashi M, Murakami M. Mycotic coronary artery aneurysm causing chest pain detected by transthoracic echocardiography: a potential blind spot of routine screening in parasternal short axis view. J Med Ultrason (2001) 2020; 47:649-651. [PMID: 32989595 DOI: 10.1007/s10396-020-01053-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Toshimitsu Kato
- Department of Clinical Laboratory, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Noriaki Takama
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Kazufumi Aihara
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Tomonari Harada
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masaru Obokata
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masahiko Kurabayashi
- Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masami Murakami
- Department of Clinical Laboratory, Gunma University Hospital, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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Ray M, McGee M, Collins N, Cooke H. Rapidly expanding saphenous vein graft myoctic aneurysm causing ST-elevation myocardial infarction: a case report. EUROPEAN HEART JOURNAL-CASE REPORTS 2020; 4:1-5. [PMID: 32352057 PMCID: PMC7180533 DOI: 10.1093/ehjcr/ytaa021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/23/2019] [Accepted: 01/21/2020] [Indexed: 11/13/2022]
Abstract
Background Mycotic aneurysms of coronary vein grafts are rare and associated with high mortality. They are most commonly a result of surgical or percutaneous intervention, and present with complications including myocardial infarction (MI), infective endocarditis. A recent literature review identified 97 cases of mycotic coronary aneurysms in total. Case summary A 49-year-old man with a history of coronary artery bypass grafting and septic arthrithis presented with chest pain and fevers and ST elevation on electrocardiogram. Urgent angiogram showed an aneurysmal saphenous vein graft from the PL branch to PDA-no acute intervention was performed due to concern about bacteraemia. Methicillin-sensitive Staphylococcus aureus was grown in urine and blood but no focus of infection was identified. Despite treatment with antibiotics and antiplatelets, the patient returned with evidence of expansion of the SVG aneurysm requiring surgical resection. Discussion This case highlights the difficulty in treating acute coronary syndromes involving mycotic aneurysms. Multimodal imaging approaches are useful to identify suspected infection, but false negatives occur. Due to high risk of rupture or haemorrhage, there are limited options for urgent reperfusion in cases of MI with mycotic aneurysm, demonstrating the need for an individualized approach and close follow-up.
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Affiliation(s)
- Max Ray
- Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle 2305, New South Wales, Australia
| | - Michael McGee
- Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle 2305, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia
| | - Nicholas Collins
- Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle 2305, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia
| | - Heather Cooke
- Cardiovascular Department, John Hunter Hospital, Lookout Road, New Lambton Heights, Newcastle 2305, New South Wales, Australia.,University of Newcastle, Newcastle, New South Wales, Australia
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