Giant right coronary artery aneurysm with a huge intramural thrombus

Dual Aneurysms of the Left Anterior Descending Coronary Artery Initially Detected by Echocardiography

Echocardiographic detection of abnormalities occurring medially and distally in coronary arteries is uncommon and is not well recognized. Herein, we describe an 87-year-old woman with two distinct aneurysms involving a branch of the left anterior descending coronary artery (LAD), one of which communicated with the pulmonary artery (PA). Initially determined via transthoracic echocardiography (TTE), these findings were subsequently validated by coronary computed tomography angiography (CTA). We also present a review of the published studies of multiple coronary artery aneurysms (CAAs) exceeding 20 mm in diameter, focusing on the location, etiology, symptoms, and common ultrasonic characteristics of 30 cases. Echocardiography is a valuable, noninvasive technique for initial detection, monitoring, and follow-up of CAAs, serving to direct further diagnostics.

Redo Operation of Recurrent Giant Coronary Artery Aneurysm: Optimizing Surgical Strategy

Background Giant coronary artery aneurysms (GCAA) are extremely rare, but they can cause life-threatening complications. Indications for surgical intervention are the occurrence of complications such as fistulas, compression, embolization, or rapid enlargement. The optimal therapeutic approach is still under debate.

Until now, there are no publications dealing with the follow-up after surgical treatment. Moreover, the surgical strategy in redo operations has not been described yet.

Case Description We report on surgery in a 50-year-old man with a recurrent GCAA after previous dissection and reduction.

Conclusion Our recommendation is complete resection and bypassing instead of a mere diameter reduction to avoid further progression of the disease.

Right coronary artery aneurysm: an unusual cause of chest pain

Giant coronary artery aneurysm is an uncommon but well-recognised entity in infants and children with Kawasaki disease. We describe an unusual case of ischaemic cardiomyopathy in an 86-year-old woman owing to giant aneurysm in a dominant right coronary artery discovered with left heart catheterisation and was missed on ECG and nuclear studies. This case highlights the importance of early diagnosis which allows appropriate management. Transcatheter therapy is the main treatment option in this case; however, medical therapy can be used alone with variable results and outcome.