1
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Somsen YB, Porouchani S, de Winter RW, Zandbergen HR, Jansen EK, Nap A, Niessen HW, Knaapen P. Unmasking of a Giant Coronary Aneurysm by Chronic Total Coronary Occlusion Percutaneous Coronary Intervention Techniques. JACC Case Rep 2024; 29:102359. [PMID: 38725652 PMCID: PMC11079459 DOI: 10.1016/j.jaccas.2024.102359] [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: 02/06/2024] [Revised: 03/25/2024] [Accepted: 03/27/2024] [Indexed: 05/12/2024]
Abstract
A young female patient presenting with a non-ST-segment elevation myocardial infarction underwent invasive coronary angiography, revealing a total occlusion of the right coronary artery. During percutaneous coronary intervention with dual catheter access, a retrograde tip injection and peculiar retrograde wiring unmasked a giant coronary aneurysm, which noninvasive imaging confirmed.
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Affiliation(s)
- Yvemarie B.O. Somsen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Sina Porouchani
- Department of Cardiology, Lille University Hospital, Lille, France
| | - Ruben W. de Winter
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Harmen R. Zandbergen
- Department of Cardiothoracic Surgery, Amsterdam UMC, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - Evert K. Jansen
- Department of Cardiothoracic Surgery, Amsterdam UMC, Amsterdam Medical Center, Amsterdam, the Netherlands
| | - Alexander Nap
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Hans W.M. Niessen
- Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Paul Knaapen
- Department of Cardiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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2
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Alfawara MS, Modi V, Chao MF, Nayfeh M, Alahdab F, Alrifai M, Al-Mallah M. Left Upper Extremity Pain, Right Coronary Artery Culprit: A Puzzling Path to Aneurysm Discovery. Methodist Debakey Cardiovasc J 2024; 20:14-17. [PMID: 38618608 PMCID: PMC11011955 DOI: 10.14797/mdcvj.1287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 02/10/2024] [Indexed: 04/16/2024] Open
Abstract
Giant coronary artery aneurysm (GCA) is a rare disease afflicting 0.2% of the population. It is primarily attributed to atherosclerosis in adults and Kawasaki disease in children. Other uncommon etiologies include Takayasu arteritis and post-percutaneous coronary intervention.1,2 GCA lacks a universally accepted definition, with proposed criteria including a diameter exceeding 2 cm, 5 cm, or four times the normal vessel size.3 While the majority of GCAs are asymptomatic, a subset of patients present with angina, myocardial infarction from embolization or compression, heart failure due to fistula formation, or even sudden death.1 We report a case of an adult harboring a GCA involving the right coronary artery.
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Affiliation(s)
- Moath Said Alfawara
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Vivek Modi
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Min-Fang Chao
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Malek Nayfeh
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Fares Alahdab
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Mahmoud Alrifai
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
| | - Mouaz Al-Mallah
- Houston Methodist DeBakey Heart & Vascular Center, Houston Methodist, Houston, Texas, US
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3
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Vassilikou A, Xenitopoulou MP, Ziampa K, Evangeliou AP, Mitsiadis S, Syrnioti A, Petrakis G, Tossios P, Vassilikos V, Tzikas S. Acute myocardial infarction due to giant coronary artery aneurysm and arteriovenous fistula: a challenging case report and review of the literature. BMC Cardiovasc Disord 2024; 24:187. [PMID: 38561678 PMCID: PMC10986014 DOI: 10.1186/s12872-024-03851-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/19/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND A coronary artery aneurysm (CAA) is an abnormal dilation of a coronary artery segment often accompanied by coronary artery fistula (CAF), leading to communication between a coronary artery and a cardiac chamber or a part of the coronary venous system. Both CAAs and CAFs can present with symptoms and signs of myocardial ischemia and infarction. CASE PRESENTATION We describe the case of a 46-year-old woman with non-ST-elevation myocardial infarction (NSTEMI) caused by a "giant" CAA. Various imaging modalities revealed a thrombus-containing aneurysm located at the right-posterior cardiac border, with established arteriovenous communication with the distal part of left circumflex artery (LCx). After initial treatment with dual antiplatelet therapy, a relapse of pain was reported along with a new increase in troponin levels, electrocardiographic abnormalities, reduced left ventricular ejection fraction (LVEF) and thrombus enlargement. Surgical excision of the aneurysm was favored, revealing its true size of 6 cm in diameter. Τhe aneurysm was excised without complications. The patient remained asymptomatic during follow-up. CONCLUSIONS Management of rare entities such as "giant" CAAs and CAFs can be challenging. Cases such as this can serve as precedents to facilitate treatment plans and develop consistent recommendations, emphasizing the importance of personalized strategies for future patients.
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Affiliation(s)
- A Vassilikou
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - M P Xenitopoulou
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - K Ziampa
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A P Evangeliou
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Mitsiadis
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - A Syrnioti
- Pathology Department, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - G Petrakis
- Pathology Department, "AHEPA" University Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - P Tossios
- Cardiothoracic Surgery Department, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - V Vassilikos
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - S Tzikas
- 3rd Department of Cardiology, "Hippokration" General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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4
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Scarpa J, Zhu A, Morikawa NK, Chan JM. Perioperative Management of Giant Coronary Artery Aneurysm. J Cardiothorac Vasc Anesth 2023; 37:2040-2045. [PMID: 37296024 DOI: 10.1053/j.jvca.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Affiliation(s)
- Julia Scarpa
- Department of Anesthesiology, New York Presbyterian Hospital-Weill Cornell Medical Center, New York, NY
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5
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Lionakis N, Briasoulis A, Zouganeli V, Koutoulakis E, Kalpakos D, Xanthopoulos A, Skoularigis J, Kourek C. Coronary artery aneurysms: Comprehensive review and a case report of a left main coronary artery aneurysm. Curr Probl Cardiol 2023; 48:101700. [PMID: 36931332 DOI: 10.1016/j.cpcardiol.2023.101700] [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: 03/08/2023] [Accepted: 03/08/2023] [Indexed: 03/17/2023]
Abstract
Coronary artery aneurysms (CAAs) are rare anatomical disorders of the coronary arteries. Atherosclerosis and Kawasaki disease are the principal causes of CCAs, while other causes including genetic factors, inflammatory arterial diseases, connective tissue disorders, endothelial damage after cocaine use, iatrogenic complications after interventions and infections, are also common among patients with CAAs. Although there is a variety of non-invasive methods including echocardiography, computed tomography, and magnetic resonance imaging, coronary angiography remains the gold standard diagnostic method. There is still no consensus about the most appropriate therapeutic strategy. Medical therapy including antiplatelets, anticoagulants, statins and ACEs are preferred either in patients with atherosclerosis, inflammatory status and stable CAAs, while percutaneous or surgery interventions are usually applied in patients with acute coronary syndrome due to a CAA culprit, obstructive coronary artery disease or large saccular aneurysms at a high risk of rupturing.
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Affiliation(s)
- Nikolaos Lionakis
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Alexandros Briasoulis
- Department of Clinical Therapeutics, Alexandra Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 11528, Greece; Division of Cardiovascular Medicine, Section of Heart Failure and Transplantation, University of Iowa Hospitals and Clinics, IA 52242, United States
| | - Virginia Zouganeli
- Second Cardiology Department, Attikon University Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens 12462, Greece
| | - Emmanouil Koutoulakis
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Dionisios Kalpakos
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece
| | - Andrew Xanthopoulos
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - John Skoularigis
- Department of Cardiology, University Hospital of Larissa, Larissa 41110, Greece
| | - Christos Kourek
- Department of Cardiology, 417 Army Share Fund Hospital of Athens (NIMTS), Athens 11521, Greece.
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6
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Kirkman T, Ahmad M, Javeed M, Agarwal S, Akel R. Rapidly enlarging mycotic coronary artery aneurysm caused by bacterial seeding involving methicillin-sensitive Staphylococcus aureus and Klebsiella pneumoniae. J Cardiol Cases 2022; 25:170-172. [DOI: 10.1016/j.jccase.2021.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/25/2021] [Accepted: 08/30/2021] [Indexed: 11/30/2022] Open
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7
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A rare case: A giant right coronary artery aneurysm mimicking a paracardiac mass. JOURNAL OF SURGERY AND MEDICINE 2022. [DOI: 10.28982/josam.848828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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8
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Andreoli C, Biscottini E, Helou J, Crusco F, Marchetti F, Scarpignato M. A giant isolated right coronary aneurism. BJR Case Rep 2021; 7:20200208. [PMID: 35047200 PMCID: PMC8749390 DOI: 10.1259/bjrcr.20200208] [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: 12/07/2020] [Revised: 02/11/2021] [Accepted: 02/28/2021] [Indexed: 12/02/2022] Open
Abstract
A previously healthy 32-year-old female hailing from Mexico presented to the emergency department with rectorrhagia. Caseating granulomas were detected on histopathological analysis from cecum ulcerative lesions. A purified protein derivative skin test resulted positive. In order to exclude pulmonary tubercolosis, a CT lung scan was performed: a rounded and voluminous mass, located above the right atrioventricular cardiac junction, was unexpectedly revealed. Further, a cardiac magnetic resonance and a coronary angiography disclosed a giant (5 × 4,8 cm) isolated aneurysm of proximal right coronary artery with severe thrombotic layering. The patient was treated with isoniazid, rifampin, ethambutol, and pyrazinamide; after approximately 2 months of treatment, she had complete resolution of cecal lesions. Anticoagulant oral therapy with warfarin was started and the patient was submitted to coronary artery grafting bypass surgery.
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Affiliation(s)
- Chiara Andreoli
- Department of Cardiology, S.G.Battista Hospital, Foligno (PG), Italy
| | - Emilia Biscottini
- Department of Cardiology, S.G.Battista Hospital, Foligno (PG), Italy
| | - Johny Helou
- Department of Cardiology, S.G.Battista Hospital, Foligno (PG), Italy
| | - Federico Crusco
- Radiology Department, S.M. della Misericordia Hospital, Perugia, Italy
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9
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Khouzam MS, Khouzam N. Giant coronary artery aneurysms involving more than one coronary artery: case report. J Cardiothorac Surg 2021; 16:177. [PMID: 34147120 PMCID: PMC8214775 DOI: 10.1186/s13019-021-01560-5] [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: 03/29/2021] [Accepted: 06/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. CASE PRESENTATION We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography, she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 × 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. CONCLUSION The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications.
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Affiliation(s)
- Matthew S Khouzam
- Loyola University Medical Center, Stritch School of Medicine, Maywood, IL, USA.
| | - Nayer Khouzam
- Division of Cardiothoracic Surgery, Advent Health, Orlando, Florida, USA
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10
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Kwon Y, Park CB, Kang PJ, Cho WC. Eighteen Years of Follow-up after Resection of a Giant Coronary Artery Aneurysm and Reconstruction with a Vein Graft. J Chest Surg 2021; 54:221-223. [PMID: 33173019 PMCID: PMC8181689 DOI: 10.5090/jcs.20.109] [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: 08/18/2020] [Revised: 09/28/2020] [Accepted: 10/05/2020] [Indexed: 11/30/2022] Open
Abstract
Giant coronary artery aneurysms are rare and challenging to treat because of variation in the presenting symptoms and the lack of established management guidelines. We report the case of a patient with a 6-cm-wide giant coronary artery aneurysm that was resected, followed by reconstruction using a saphenous vein graft and 18 years of follow-up.
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Affiliation(s)
- Yelee Kwon
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Chong Bin Park
- Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Pil Je Kang
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Won Chul Cho
- Department of Thoracic and Cardiovascular Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
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11
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Bjelobrk M, Dodic S, Miljkovic T, Samardzija G, Bjeljac I, Dabovic D, Dodic B, Rosic M, Kovacevic M, Redzek A, Fabri M. Asymptomatic Giant Aneurysm of the Left Anterior Descending Coronary Artery: A Case Report and Review of the Literature. J Tehran Heart Cent 2021; 15:178-182. [PMID: 34178087 PMCID: PMC8217192 DOI: 10.18502/jthc.v15i4.5944] [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] [Indexed: 11/24/2022] Open
Abstract
The most common cause of coronary artery aneurysms is atherosclerosis, which is associated with over 50% of all aneurysms diagnosed in adults. Although patients can be asymptomatic throughout their lives, giant coronary artery aneurysms can manifest themselves as myocardial infarction, aneurysmal rupture, and sudden cardiac death as well. Herein, we describe an asymptomatic patient with numerous risk factors and a positive cardiopulmonary exercise test who was admitted to the cardiology clinic for coronary angiography. A giant coronary artery aneurysm (3.0×2.0 cm in diameter) in the left anterior descending coronary artery and significant stenosis in both left and right coronary arteries were found. After discussing possible treatment options, the hospital's heart team recommended the surgical resection of the aneurysm and double coronary artery bypass graft. Four years after the cardiac surgery, at the time of writing the current manuscript, the patient is still in good condition and with no symptoms.
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Affiliation(s)
- Marija Bjelobrk
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Slobodan Dodic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Tatjana Miljkovic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Golub Samardzija
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Ilija Bjeljac
- Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Dragana Dabovic
- Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | | | - Milenko Rosic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Mila Kovacevic
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Aleksandar Redzek
- University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.,Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
| | - Miklos Fabri
- Institute of Cardiovascular Diseases Vojvodina, Clinic of Cardiology, Sremska Kamenica, Serbia
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12
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Salwan AS, Mohammedzein AIA, Alzeerah MA. Incomplete Kawasaki disease with a giant coronary artery aneurysm; an unexpected finding in an adult male. IJC HEART & VASCULATURE 2021; 34:100756. [PMID: 33816768 PMCID: PMC8008183 DOI: 10.1016/j.ijcha.2021.100756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Anu S Salwan
- Cardiology, Texas Cardiac Arrhythmia Institute, Austin, TX, USA
| | | | - Masoud A Alzeerah
- Cardiothoracic Surgery, Thomas E. Creek Medical Center, Amarillo, TX, USA
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13
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Belayneh DK, Calais F. Asymptomatic giant right coronary artery aneurysm in Kawasaki disease: A case report. Clin Case Rep 2020; 8:2732-2738. [PMID: 33363814 PMCID: PMC7752556 DOI: 10.1002/ccr3.3259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 07/24/2020] [Accepted: 08/01/2020] [Indexed: 12/19/2022] Open
Abstract
Incidentally diagnosed giant coronary artery aneurysms (gCAA) exceeding 50 mm in diameter are extremely rare and carry increased risks of cardiovascular morbidity and mortality. Currently, surgery is the preferred treatment for such gCAA.
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Affiliation(s)
| | - Fredrik Calais
- Department of CardiologyFaculty of HealthÖrebro UniversityÖrebroSweden
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14
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Meel R, Lorentz L, Gonçalves R. Multimodality Imaging of a Giant Circumflex Coronary Artery Aneurysm in a Septuagenarian. CASE 2020; 4:236-239. [PMID: 32875188 PMCID: PMC7451935 DOI: 10.1016/j.case.2020.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Coronary artery aneurysm is a possible differential diagnosis for chest pain. Echocardiography allows bedside detection of coronary artery aneurysm. Cardiac CT permits detailed assessment of a coronary artery aneurysm.
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Affiliation(s)
- Ruchika Meel
- Division of Cardiology, Department of Internal Medicine, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - Liam Lorentz
- Department of Radiology, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
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15
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Altarabsheh SE, Deo SV, Rababa'h A, Mayaah S, Alkhasawneh M, Alhabahbeh DA, Obeidat YM. Giant right coronary artery aneurysm in the setting of the acute coronary syndrome: A case report. J Card Surg 2020; 35:2379-2381. [PMID: 32652673 DOI: 10.1111/jocs.14717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Giant right coronary artery (RCA) aneurysm is a rare coronary artery pathology. We describe a 45-year-old gentleman who presented with unstable angina of recent onset. Diagnostic workup including chest computed tomography angiography and left heart catheterization demonstrated three-vessel coronary artery disease with giant proximal RCA aneurysm. In the view of the severity of the coronary artery disease and the risk of rupture associated with the giant RCA aneurysm and the clinical presentation, the patient was successfully treated by coronary artery bypass surgery. During this procedure, the RCA aneurysm was ligated at both inflow and outflow. The patient recovered well and was discharged home.
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Affiliation(s)
- Salah E Altarabsheh
- Division of Cardiovascular Surgery, Queen Alia Heart Institute, Amman, Jordan
| | - Salil V Deo
- Department of Cardiac Surgery, Surgical Services, Louis Stokes Cleveland VA Medical Center, Cleveland, Ohio
| | - Abeer Rababa'h
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Sakher Mayaah
- Division of Cardiovascular Surgery, Queen Alia Heart Institute, Amman, Jordan
| | | | - Dalia A Alhabahbeh
- Department of Internal Medicine, King Hussein Medical Center, Amman, Jordan
| | - Yagthan M Obeidat
- Department of Cardiac Surgery, AlMana General Hospital, AL Khobar, Saudi Arabia
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16
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Unique Findings and Novel Treatment Strategy of a Giant Coronary Artery Aneurysm Associated with a Significant Pericardial Effusion. Case Rep Cardiol 2020; 2020:8890806. [PMID: 32566321 PMCID: PMC7303761 DOI: 10.1155/2020/8890806] [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: 04/06/2020] [Revised: 05/05/2020] [Accepted: 05/15/2020] [Indexed: 11/18/2022] Open
Abstract
Giant coronary artery aneurysms are a rare, asymptomatic occurrence. Presently, there is a lack of substantial research performed in the U.S., likely due to its low prevalence. As we are increasingly becoming a global community, strengthening data for seemingly rare disease processes such as this need to be addressed, particularly when they can progress to involve complications such as pericardial effusion caused by aneurysmal rupture or infection. A popular treatment option for these aneurysms is polytetrafluoroethylene-covered stents; they have been favorable with obtaining a high percentage of procedural success rates in aneurysms not associated with myocardial infarctions. In this paper, we present a case of a giant coronary artery aneurysm located in the left circumflex coronary artery that was complicated by a pericardial effusion. We will also present its unusual repair using a long drug-eluting stent as a scaffold to overlap covered coronary stents used to help exclude the aneurysm.
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17
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Raut MS, Hanjoora VM, Srivastava AR, Khangarot SS, Jyoti A, Mahajan V, Rawal N. Congenital giant right coronary artery. Ann Card Anaesth 2020; 23:230-231. [PMID: 32275044 PMCID: PMC7336982 DOI: 10.4103/aca.aca_181_18] [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] [Indexed: 11/10/2022] Open
Abstract
Giant coronary artery aneurysms are exceptionally uncommon with an incidence of 0.02%. The natural history and prognosis of giant coronary artery aneurysm are still not well known.
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Affiliation(s)
- Monish S Raut
- Department of Cardiac Anesthesia, Artemis Hospital, Gurugram, Haryana, India
| | - Vijay M Hanjoora
- Department of Cardiac Anesthesia, Artemis Hospital, Gurugram, Haryana, India
| | | | | | - Aman Jyoti
- Department of Cardiac Anesthesia, Artemis Hospital, Gurugram, Haryana, India
| | - Viresh Mahajan
- Department of Pediatric Cardiology, Artemis Hospital, Gurugram, Haryana, India
| | - Nidhi Rawal
- Department of Pediatric Cardiology, Artemis Hospital, Gurugram, Haryana, India
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18
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Hernández-Mejía BI, Espinoza-Saquicela ER. Giant right coronary artery aneurysm. Case Report. CASE REPORTS 2020. [DOI: 10.15446/cr.v6n1.82446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.
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19
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Pham V, Hemptinne QD, Grinda JM, Duboc D, Varenne O, Picard F. Giant coronary aneurysms, from diagnosis to treatment: A literature review. Arch Cardiovasc Dis 2020; 113:59-69. [DOI: 10.1016/j.acvd.2019.10.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 10/17/2019] [Accepted: 10/23/2019] [Indexed: 12/26/2022]
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20
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Kurnauth V, Morey M, Jarvis R. Giant right coronary artery aneurysm - A rare presentation. J Med Imaging Radiat Oncol 2019; 64:252-254. [PMID: 31799794 DOI: 10.1111/1754-9485.12980] [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: 08/26/2018] [Accepted: 10/13/2019] [Indexed: 11/30/2022]
Abstract
Coronary artery aneurysm (CAA) is focal dilatation of a coronary artery 1.5 times or more its normal size (Res Cardiovasc Med, 2016; 5: e32086). Coronary artery aneurysm is found in 1.2-4.9% of diagnostic coronary angiography and 1.4% at post-mortem (Heart Views, 2014; 15: 13; Clin Cardiol, 2015; 29: 439). The proximal and middle segments of the right coronary artery (RCA) are most commonly involved, followed by the proximal left anterior descending (LAD) and the left circumflex arteries. The left main stem rarely develops aneurysms (Clin Cardiol, 2015; 29: 439). A giant aneurysm is a CAA> 2 cm. Giant coronary artery aneurysms (GCAA) are rare (incidence 0.02%) although cause serious complications. [4] Given the rarity of this disease, there is limited information in the literature on its presentation and there is no consensus on its optimal management option. We report a case of a GCAA with an atypical presentation and describe its management. This will add to the current small database on CAA to provide clinicians a better insight on the disease.
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21
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Crabbe J, Hussain A, Vijayan A, John J, Loubani M. Giant right coronary artery aneurysm presenting as an STEMI. J Surg Case Rep 2019; 2019:rjz282. [PMID: 31700600 PMCID: PMC6827552 DOI: 10.1093/jscr/rjz282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 08/23/2019] [Indexed: 12/04/2022] Open
Abstract
Giant coronary artery aneurysms are an infrequent finding. They are typically discovered incidentally, rarely presenting with any symptoms. We present the case of a 72-year-old gentleman who presented with an ST elevated myocardial infarction. On investigation, the gentleman was found to have a giant right coronary artery aneurysm which was partially filled with a fresh thrombus. The thrombus occluded the RCA, triggering the myocardial infarction which leads to this gentleman’s presentation to a tertiary cardiac centre. The gentleman underwent a successful resection of the aneurysm and coronary artery bypass graft over the RCA lesion with a saphenous vein conduit. This gentleman has since been discharged from hospital after an uncomplicated postoperative course.
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Affiliation(s)
- Jennifer Crabbe
- Department of Cardiothoracic Surgery,Department of Cardiothoracic Anaesthesia,Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK
| | - Azar Hussain
- Department of Cardiothoracic Surgery,Department of Cardiothoracic Anaesthesia,Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK
| | - Ajith Vijayan
- Department of Cardiothoracic Surgery,Department of Cardiothoracic Anaesthesia,Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK
| | - Joseph John
- Department of Cardiothoracic Surgery,Department of Cardiothoracic Anaesthesia,Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK
| | - Mahmoud Loubani
- Department of Cardiothoracic Surgery,Department of Cardiothoracic Anaesthesia,Department of Cardiology, Hull University Teaching Hospitals NHS Trust, Castle Hill Hospital, Castle Road, Cottingham HU16 5JQ, UK
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22
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Yeung DF, Kiamanesh O, Girgis H, Hong J, Turaga M, Gin K, Wong GC, Janusz M, Tsang MYC, Tsang TSM, Nair P, Jue J. Rupture of a Coronary Artery Aneurysm and Fistula to the Pulmonary Artery. Circ Cardiovasc Imaging 2019; 12:e009516. [PMID: 31522553 DOI: 10.1161/circimaging.119.009516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Darwin F Yeung
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Omid Kiamanesh
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Hany Girgis
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Jonathan Hong
- Department of Cardiovascular Surgery (J.H., M.J.), University of British Columbia, Vancouver, Canada
| | - Mansi Turaga
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Kenneth Gin
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Graham C Wong
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Michael Janusz
- Department of Cardiovascular Surgery (J.H., M.J.), University of British Columbia, Vancouver, Canada
| | - Michael Y C Tsang
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Teresa S M Tsang
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - Parvathy Nair
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
| | - John Jue
- Division of Cardiology (D.F.Y., O.K., H.G., M.T., K.G., G.C.W., M.Y.C.T., T.S.M.T., P.N., J.J.), University of British Columbia, Vancouver, Canada
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23
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Ramirez JL, Kratz JR, Wieselthaler GM. Giant right coronary artery aneurysm presenting as cardiac tamponade. Interact Cardiovasc Thorac Surg 2019; 27:787-789. [PMID: 29800339 DOI: 10.1093/icvts/ivy166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 04/22/2018] [Indexed: 11/14/2022] Open
Abstract
Giant coronary artery aneurysms are rare and have variable presentations, which range from an incidental finding to sudden death. We report a case of a female presenting with chest pain and signs of cardiac tamponade who underwent a computed tomography (CT) pulmonary embolus protocol and was found to have haemopericardium with accumulation of contrast adjacent to the aorta. She underwent emergent sternotomy and was found to have a ruptured giant right coronary artery aneurysm, which was ligated and bypassed. This report highlights the difficulty of diagnosing a ruptured giant coronary artery aneurysm via CT and provides valuable information on an atypical presentation.
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Affiliation(s)
- Joel L Ramirez
- Division of Adult Cardiothoracic Surgery, Department of Surgery, San Francisco, CA, USA
| | - Johannes R Kratz
- Division of Adult Cardiothoracic Surgery, Department of Surgery, San Francisco, CA, USA
| | - Georg M Wieselthaler
- Division of Adult Cardiothoracic Surgery, Department of Surgery, San Francisco, CA, USA
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24
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Shen J, Zhou Y, Fang Z, Hu J. Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report. BMC Surg 2019; 19:80. [PMID: 31277612 PMCID: PMC6612139 DOI: 10.1186/s12893-019-0547-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 06/25/2019] [Indexed: 02/05/2023] Open
Abstract
Background The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instability who was diagnosed with multiple giant CAAs combined with RCA-PA fistula. Case presentation The patient, a 60-year-old female, presented to the emergency room because of progressive exertional chest distress and fatigue. The transthoracic echocardiography (TTE), coronary computed tomography angiography (CTA) and invasive coronary angiography confirmed the existence of multiple giant CAAs and RCA-PA fistula. Laboratory examinations for systemic vasculitis and infectious diseases demonstrated no abnormalities and work-up for childhood and family history were negative. We have performed a successful surgical treatment for this patient. The patient’s restrictive cardiac dysfunction was improved after debriding the advanced thrombi in aneurysm sac and ligating the fistulous vessel between the native RCA and PA. The postoperative pathologic examination of the aneurysmal wall revealed loss of smooth muscle cells in the media with local mucoid degeneration, no chronic inflammation, sclerosis and IgG4 were observed. Conclusions The treatment decision-making process should depend upon the patients’ specific situations. Our case suggests the surgical intervention should be accepted as the preferred treatment for giant CAAs with restrictive cardiac dysfunction. Electronic supplementary material The online version of this article (10.1186/s12893-019-0547-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jiayu Shen
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, No.37 Guo Xue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Yang Zhou
- Department of Cardiothoracic Surgery, People's Hospital of Leshan, No.238 Bai Ta Street, Leshan, 614000, China
| | - Zhi Fang
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, No.37 Guo Xue Alley, Chengdu, Sichuan, 610041, People's Republic of China
| | - Jia Hu
- Department of Cardiovascular Surgery, West China Hospital of Sichuan University, No.37 Guo Xue Alley, Chengdu, Sichuan, 610041, People's Republic of China.
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25
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Cotter R, Krantz M, Hogan S, Holland M. Exclusion of a Giant Coronary Artery Aneurysm With Covered Stents Using a Long Drug-Eluting Stent Scaffold. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2019; 12:1179547619828689. [PMID: 30792579 PMCID: PMC6376528 DOI: 10.1177/1179547619828689] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 01/10/2019] [Indexed: 12/18/2022]
Abstract
Coronary artery aneurysms (CAA) are a rare cause of acute coronary syndrome and there is little consensus as to the optimal treatment. Based on case series as well as expert opinion, surgery has been suggested as the optimal treatment for a giant CAA. Here, we present the case of a patient with recurrent myocardial infarction and severe angina due to a giant CAA, who was deemed a poor surgical candidate due to his multiple medical comorbidities. Given his intractable anginal symptoms despite medical therapy, he chose to pursue percutaneous intervention. However, the aneurysm was larger than available covered coronary stents and the patient had significant atherosclerotic disease proximal and distal to the aneurysm itself. Our approach used a long drug-eluting stent as a scaffold to overlap covered coronary stents to successfully exclude the aneurysm. The patient’s angina resolved and had no complications or readmissions after nearly 1 year of follow-up.
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Affiliation(s)
- Ryan Cotter
- Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Denver Health Medical Center, Denver CO, USA
| | - Mori Krantz
- Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Denver Health Medical Center, Denver CO, USA
| | - Shea Hogan
- Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Denver Health Medical Center, Denver CO, USA
| | - Matthew Holland
- Division of Cardiology, School of Medicine, University of Colorado, Aurora, CO, USA.,Division of Cardiology, Denver Health Medical Center, Denver CO, USA
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26
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Haque H, Zohourian H. Outcome of a giant coronary artery mycotic pseudoaneurysm secondary to non-typhoid Salmonella managed without surgical intervention. BMJ Case Rep 2019. [DOI: 10.1136/bcr-2018-227104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 48-year-old woman with a history of AIDS, a recent coronary artery bypass graft operation and prior bacteraemia with non-typhoid Salmonella presented with non-exertional chest pain and elevated troponins. The cardiac catheterisation and coronary CT angiography revealed a 9 cm pseudoaneurysm arising from the proximal left anterior descending artery. The blood cultures confirmed non-typhoid Salmonella. Emergent surgery was initially deferred due to her complex anatomy. Moreover, the hospital course was complicated by Epstein-Barr virus meningitis and an associated decline in the patient’s mentation. Consequently, the mycotic pseudoaneurysm was medically managed with antibiotics and strict blood pressure goals. The natural history of giant mycotic coronary artery pseudoaneurysm formation and progression is appreciated through this first reported medically managed case. The follow-up coronary CT angiography at 3 months showed evidence of pseudoaneurysm leakage into surrounding tissue. The patient expired at 5 months from an unknown cause.
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27
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Libertini R, Wallbridge D, Jones HR, Gunning M, Satur CM. Giant Circumflex Artery Aneurysm With a Coronary Sinus Fistula. Ann Thorac Surg 2018; 106:e223-e225. [DOI: 10.1016/j.athoracsur.2018.04.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 04/12/2018] [Indexed: 10/16/2022]
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28
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Nor FM, Shafee S, Tan RZ, Tan LJ. Another cause of cardiac tamponade: ruptured coronary artery aneurysm. EGYPTIAN JOURNAL OF FORENSIC SCIENCES 2018. [DOI: 10.1186/s41935-018-0089-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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29
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Multiple Giant Coronary Artery Aneurysms Surgically Treated with Bypass Grafting: A Challenging Rarity. Case Rep Surg 2018; 2018:2096902. [PMID: 30228924 PMCID: PMC6136512 DOI: 10.1155/2018/2096902] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 05/15/2018] [Accepted: 07/22/2018] [Indexed: 01/08/2023] Open
Abstract
Coronary artery aneurysms are encountered in daily cardiology practise but multiple giant-sized coronary artery aneurysms are extremely rare. We present an illustrative case of multiple giant aneurysms located throughout the coronary system (left main stem and all left, right, and circumflex branches) in a 57-year-old male with acute coronary syndrome. The case was managed successfully with on-pump quadruple coronary artery bypass grafting. To our knowledge, few cases of multiple giant aneurysms in all coronary vessels have been reported.
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30
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Severe Dilatation of Coronary Artery Ostium Complicating Sinus of Valsalva Aneurysm: Differential Diagnosis and Review of the Literature. Case Rep Cardiol 2017; 2017:8694652. [PMID: 28487777 PMCID: PMC5406726 DOI: 10.1155/2017/8694652] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/26/2017] [Indexed: 11/17/2022] Open
Abstract
Coronary artery dilatation may be due to various aetiologies including congenital anomalies, atherosclerotic coronary disease, and Kawasakis disease. We describe a case characterised by apparent severe dilatation of the right coronary artery ostium in an asymptomatic male. Subsequent imaging and surgical intervention documented the presence of a sinus of Valsalva aneurysm extending into the ostium of the right coronary artery. This represents an unusual manifestation of a sinus of Valsalva aneurysm. The underlying pathophysiology, differential diagnosis, role of surgical management, and outcomes are discussed.
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31
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Abou Sherif S, Ozden Tok O, Taşköylü Ö, Goktekin O, Kilic ID. Coronary Artery Aneurysms: A Review of the Epidemiology, Pathophysiology, Diagnosis, and Treatment. Front Cardiovasc Med 2017; 4:24. [PMID: 28529940 PMCID: PMC5418231 DOI: 10.3389/fcvm.2017.00024] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Accepted: 04/07/2017] [Indexed: 12/11/2022] Open
Abstract
Coronary artery aneurysms (CAAs) are uncommon and describe a localized dilatation of a coronary artery segment more than 1.5-fold compared with adjacent normal segments. The incidence of CAAs varies from 0.3 to 5.3%. Ever since the dawn of the interventional era, CAAs have been increasingly diagnosed on coronary angiography. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease (KD), and percutaneous coronary intervention. The natural history of CAAs remains unclear; however, several recent studies have postulated the underlying molecular mechanisms of CAAs, and genome-wide association studies have revealed several genetic predispositions to CAA. Controversies persist regarding the management of CAAs, and emerging findings support the importance of an early diagnosis in patients predisposed to CAAs, such as in children with KD. This review aims to summarize the present knowledge of CAAs and collate the recent advances regarding the epidemiology, etiology, pathophysiology, diagnosis, and treatment of this disease.
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Affiliation(s)
- Sara Abou Sherif
- Cardiovascular Research Division, Kings College London, London, UK
| | - Ozge Ozden Tok
- Department of Cardiology, Memorial Hospital, Istanbul, Turkey
| | | | - Omer Goktekin
- Department of Cardiology, Memorial Hospital, Istanbul, Turkey
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32
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Li H, Zhao Y, Zhang HP, Ai H, Zheng NX, Tang GD, Sun FC. Bilateral coronary artery fistulas with a giant coronary aneurysm complicated by aneurysm rupture: A case report. Medicine (Baltimore) 2016; 95:e5445. [PMID: 27861394 PMCID: PMC5120951 DOI: 10.1097/md.0000000000005445] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Coronary artery aneurysms and fistulas are not rare conditions in clinical practice, but bilateral fistulas with a giant coronary aneurysm in just one person are quite rare. PATIENT CONCERNS We report a case of a 66-year-old woman with these 2 coronary abnormalities accompanied with a huge mediastinum mass. INTERVENTIONS The giant aneurysm was ligated and the mass was resected which was proved to be an organized hematoma finally. OUTCOMES The patient was discharged soon with no complications. LESSONS The best treatment of giant coronary aneurysm is not clear because of its rarity, surgical resection may be the right procedure for the potential serious complications like this case.
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33
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Sadeghi MM, Jouzdani SR. Giant left anterior descending coronary artery aneurysm in an adult male patient with ST elevation myocardial infarction. J Surg Case Rep 2016; 2016:rjw023. [PMID: 27021297 PMCID: PMC4809239 DOI: 10.1093/jscr/rjw023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Coronary artery aneurysm is a rare clinical entity encountered incidentally 0.3–5% among patients who undergo coronary angiography. Even giant coronary artery aneurysm is much rarer with an incidence of 0.02% among all atherosclerotic cases. Due to rare occurrence and lack of controlled trials, clinical presentation, prognosis and management of giant coronary artery aneurysm are under controversies in the literature. We report a 43-year-old male patient admitted to our hospital with a typical chest pain associated with ST elevation changes in anterior chest leads and elevated cardiac enzymes. Coronary angiography of the patient revealed a large (1.5 cm × 3 cm) aneurysm of proximal left anterior descending coronary artery. We performed a successful surgical excision and coronary bypass surgery. The patient had an uncomplicated course.
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34
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Aggarwal V, Mishkel G, Goswami N. Percutaneous exclusion of a rapidly enlarging left main coronary artery aneurysm using coils and an Amplatzer™ septal occluder. Catheter Cardiovasc Interv 2016; 88:209-14. [PMID: 26945542 DOI: 10.1002/ccd.26478] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 01/25/2016] [Accepted: 01/29/2016] [Indexed: 11/05/2022]
Abstract
Coronary artery aneurysms (CAAs) are often an incidental finding amongst patients undergoing coronary angiography. Most CAAs are managed conservatively; rarely a larger CAA can lead to intramural thrombus formation and coronary artery embolization/obstruction even without the presence of significant stenosis. Despite these clinical implications, therapeutic options are limited to case reports and no clearly defined guidelines have been established for treatment. In this article, we present a unique case of a rapidly enlarging left main CAA, with no identifiable etiology that was treated with percutaneous exclusion via coil embolization and an Amplatzer™ septal occluder device. We also discuss existing literature, pathophysiology, and management options for CAAs. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Vikas Aggarwal
- Prairie Heart Institute, St. John's Hospital, Springfield, IL
| | | | - Nilesh Goswami
- Cardiac Catheterization Laboratory, Prairie Heart Institute, Springfield, IL
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35
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Al Salihi S, Jacobi E, Hunter R, Buja M. Multiple giant coronary artery aneurysms: a case report. Cardiovasc Pathol 2016; 25:203-207. [PMID: 26878103 DOI: 10.1016/j.carpath.2016.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Revised: 12/30/2015] [Accepted: 01/05/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Coronary artery aneurysm is defined as a localized area of dilatation exceeding the diameter of the adjacent normal arterial segment by 50%. Giant aneurysms are those aneurysms that measure greater than 2cm in diameter. There have been many pathologic diseases, including atherosclerosis, that have been implicated in the development of coronary artery aneurysms. MATERIALS AND METHODS We report a case of a 61-year-old African American male with multiple comorbidities including hypertension, congestive heart failure, abdominal aortic aneurysm, and bilateral iliac aneurysms, who was admitted to our hospital with exacerbation of congestive heart failure. Less than 2weeks after admission, the patient suffered cardiac arrest while receiving dialysis and was unresponsive to resuscitative measures. FINDINGS Autopsy was performed and revealed significant cardiomyopathy and giant coronary artery aneurysms involving the left anterior descending, left circumflex, and right coronary arteries. Both ventricles showed hypertrophy and dilation with multifocal areas of chronic myocardial scarring. CONCLUSIONS Coronary artery aneurysms and giant coronary artery aneurysms are an uncommon. As there are few reported cases in the literature, the cause, detection, and treatment of this disease are still largely unknown.
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Affiliation(s)
- S Al Salihi
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - E Jacobi
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - R Hunter
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - M Buja
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
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36
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Zhang S, Liu G, Yu T, Zhou G, Zheng R. Giant right coronary artery aneurysm secondary to Kawasaki disease in child: a case report. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:9468-9470. [PMID: 26464706 PMCID: PMC4583938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 04/14/2015] [Indexed: 06/05/2023]
Abstract
Coronary artery aneurysm or ectasia was reported in approximately 15% to 25% of the affected children, particularly in the proximal end of the main blood vessel and the left anterior descending part. Rare patients have been reported with aneurysm in the distal end of the right coronary artery. In this case report, we present a rare case with aneurysm in the distal end of the right coronary artery. Multi-slice computed tomography was performed for the coronary angiography. Aspirin (10 mg/kg body weight per day) and gamma globulin (2 kg/kg body weight) was administrated via intravenous injection. The patient is currently in a healthy status with a 12-month follow up.
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Affiliation(s)
- Shanshan Zhang
- Department of Pediatrics, General Hospital, Tianjin Medical UniversityTianjin 300052, China
| | - Geli Liu
- Department of Pediatrics, General Hospital, Tianjin Medical UniversityTianjin 300052, China
| | - Tielian Yu
- Department of Ultrasound, General Hospital, Tianjin Medical UniversityTianjin 300052, China
| | - Guiming Zhou
- Department of Medical Imaging, General Hospital, Tianjin Medical UniversityTianjin 300052, China
| | - Rongxiu Zheng
- Department of Pediatrics, General Hospital, Tianjin Medical UniversityTianjin 300052, China
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37
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Wang L, Wang J, Cheng TO, Xie M, Wang X, Song Y, Liu J, Wei F. Giant left coronary artery aneurysms: Review of the literature and report of a rare case diagnosed by transthoracic echocardiography. Int J Cardiol 2015; 189:267-71. [DOI: 10.1016/j.ijcard.2015.04.082] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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38
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Tamene AM, Saxena R, Grizzard JD, Shenoy C. Asymptomatic progression of an atherosclerotic giant right coronary artery aneurysm over 12 years: characterization using cardiovascular magnetic resonance and computed tomography imaging. Circulation 2015; 131:e360-2. [PMID: 25737505 DOI: 10.1161/circulationaha.114.012275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ashenafi M Tamene
- From Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis (A.M.T., C.S.); North Memorial Heart and Vascular Institute, Minneapolis, MN (R.S.); and Department of Radiology, Virginia Commonwealth University Medical Center, Richmond, VA (J.D.G.)
| | - Retu Saxena
- From Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis (A.M.T., C.S.); North Memorial Heart and Vascular Institute, Minneapolis, MN (R.S.); and Department of Radiology, Virginia Commonwealth University Medical Center, Richmond, VA (J.D.G.)
| | - John D Grizzard
- From Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis (A.M.T., C.S.); North Memorial Heart and Vascular Institute, Minneapolis, MN (R.S.); and Department of Radiology, Virginia Commonwealth University Medical Center, Richmond, VA (J.D.G.)
| | - Chetan Shenoy
- From Cardiovascular Division, Department of Medicine, University of Minnesota Medical Center, Minneapolis (A.M.T., C.S.); North Memorial Heart and Vascular Institute, Minneapolis, MN (R.S.); and Department of Radiology, Virginia Commonwealth University Medical Center, Richmond, VA (J.D.G.).
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39
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Crawley PD, Mahlow WJ, Huntsinger DR, Afiniwala S, Wortham DC. Giant coronary artery aneurysms: review and update. Tex Heart Inst J 2014; 41:603-8. [PMID: 25593524 DOI: 10.14503/thij-13-3896] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Giant coronary artery aneurysms are rare, with a reported prevalence of 0.02% to 0.2%. Causative factors include atherosclerosis, Takayasu arteritis, congenital disorders, Kawasaki disease, and percutaneous coronary intervention. Most giant coronary artery aneurysms are asymptomatic, but some patients present with angina pectoris, sudden death, fistula formation, pericardial tamponade, compression of surrounding structures, or congestive heart failure. Clinical sequelae include thrombus formation, embolization, fistula formation, and rupture. Surgical correction is generally accepted as the preferred treatment for giant coronary artery aneurysms. We present an illustrative case of a giant 70 × 40-mm coronary artery aneurysm in a 56-year-old man who declined surgery and died one month later. In addition, we provide a review of the medical literature on giant coronary artery aneurysms.
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40
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360 degrees out of trouble: a novel wiring technique required in management of acute occlusion of a giant coronary aneurysm. JACC Cardiovasc Interv 2014; 7:939-41. [PMID: 25086844 DOI: 10.1016/j.jcin.2013.12.211] [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] [Received: 11/27/2013] [Accepted: 12/19/2013] [Indexed: 11/22/2022]
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41
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Pasteur-Rousseau A, Bouvier E, Donzeau-Gouge P, Troussier X. Double giant coronary aneurysm: improved morphological study by computed tomography. Interact Cardiovasc Thorac Surg 2014; 19:711-3. [PMID: 25006213 DOI: 10.1093/icvts/ivu212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Coronary artery aneurysm may cause coronary artery rupture, thromboembolism or haemodynamic problems related to compression. We report the case of a 68-year old man who was referred to an intensive cardiological care unit for recurrence of ventricular tachycardia. Coronary angiography revealed two large aneurysms of the mid-right coronary artery. A multislice computed tomography (CT) study demonstrated marked underestimation by invasive angiography because of the large thrombus. The patient was referred for cardiac surgery. The right mammary artery was used as a bypass graft to the distal segment of the right coronary artery and the two aneurysms were ligated proximally and distally after removal of their thrombus filling. The postoperative CT confirmed patency of the bypass graft and the vascular exclusion of the aneurysm, with no opacification. Cardiac CT is a promising tool for the comprehensive study of coronary aneurysms, both before and after surgery.
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42
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Banfi C, Vincentelli A, Ennezat PV, Midulla M, Alibrahim M, Rousse N, Prat A, Juthier F. A covered rupture of a giant right coronary artery aneurysm in the right atrium wall. Int J Cardiol 2014; 174:e120-1. [PMID: 24820754 DOI: 10.1016/j.ijcard.2014.04.184] [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] [Received: 04/15/2014] [Accepted: 04/18/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Carlo Banfi
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France.
| | - André Vincentelli
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France
| | - Pierre-Vladimir Ennezat
- Department of Cardiology, Centre Hospitalier Regional et Universitaire de Grenoble, Grenoble, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France
| | - Marco Midulla
- Department of Cardiovascular Radiology, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France
| | - Merie Alibrahim
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France
| | - Natacha Rousse
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France
| | - Alain Prat
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France
| | - Francis Juthier
- Department of Cardiovascular Surgery, Centre Hospitalier Regional et Universitaire de Lille, F-59000 Lille, France; Université Nord de France, IFR 114, EA 2693, F-59000 Lille, France
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43
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Bajaj A, Sehgal V, Bajwa SJS, Sethi A, Pancholy SB. Expanding giant right coronary artery aneurysm: an acute need for new management strategies. Heart Views 2014; 15:13-5. [PMID: 24949182 PMCID: PMC4062983 DOI: 10.4103/1995-705x.132139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Angiography use has become increasingly common worldwide. Coronary artery aneurysm may be an incidental finding during angiography. Occasionally it might be symptomatic or may become symptomatic over the course of time. Rupture of aneurysm may lead to disastrous complications. Here we present a case in which aneurysm was asymptomatic but surgical intervention was done because of rapid increase in the size of aneurysm. This is to drive home the point that timely surgical intervention is instrumental in preventing complications associated with possible rupture of the aneurysm.
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Affiliation(s)
- Anurag Bajaj
- Department of Internal Medicine, Wright Center, The Commonwealth Medical College, Scranton, PA, USA
| | - Vishal Sehgal
- Department of Internal Medicine, Commonwealth Health Regional Hospital of Scranton Clinical Assistant Professor of Medicine, The Commonwealth Medical College, Scranton, PA, USA
| | - Sukhminder Jit Singh Bajwa
- Department of Anesthesiology and Intensive Care Medicine, Gian Sagar Medical College, Banur, Patiala, India
| | - Ankur Sethi
- Department of Internal Medicine, Rosalind Franklin University of Medicine and Science, The Chicago Medical School, USA
| | - Samir B Pancholy
- Department of Internal Medicine, Wright Center, The Commonwealth Medical College, Scranton, PA, USA
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44
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Genç B, Taştan A, Abacılar AF, Akpınar MB, Uyar S. Thrombosed left circumflex artery aneurysm presenting with myocardial infarction. Asian Cardiovasc Thorac Ann 2014; 24:39-41. [PMID: 24821962 DOI: 10.1177/0218492314534846] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coronary artery aneurysms are life-threatening conditions that are quite uncommon in adults. They are observed in 1.1% to 4.9% of patients undergoing coronary angiography. They are usually located in the right coronary artery, may sometimes be thrombosed or rupture, and occasionally reach an enormous size leading to compressive symptoms. We report a case of thrombosed left circumflex artery aneurysm presenting with myocardial infarction. The thrombosed aneurysm, which could not be clearly demonstrated by coronary angiography, was definitively diagnosed by coronary computed tomography angiography. No operation was planned owing to total thrombosis of the aneurysm.
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Affiliation(s)
- Berhan Genç
- Department of Radiology, Şifa University School of Medicine, Izmir, Turkey
| | - Ahmet Taştan
- Department of Cardiology, Şifa University School of Medicine, Izmir, Turkey
| | - Ahmet Feyzi Abacılar
- Department of Cardiovascular Surgery, Şifa University School of Medicine, Izmir, Turkey
| | - Mehmet Beşir Akpınar
- Department of Cardiovascular Surgery, Şifa University School of Medicine, Izmir, Turkey
| | - Samet Uyar
- Department of Cardiology, Şifa University School of Medicine, Izmir, Turkey
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45
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Staged hybrid treatment for contained rupture of a large right coronary artery aneurysm. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2014; 9:69-71. [PMID: 24406321 DOI: 10.1097/imi.0000000000000013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We describe a staged approach to the management of a rare acute condition--contained rupture of a large right coronary artery aneurysm. A covered stent was deployed percutaneously to isolate the aneurysm at presentation followed by planned coronary bypass grafting. Treatment interval was complicated by new-onset pulmonary tuberculosis and subacute thrombosis of the covered stent leading to nonfatal inferior myocardial infarction. Coronary surgery was performed after complete antitubercular treatment and resolution of the acute pericarditis/thrombosis as a consequence of the contained rupture. The advantages of this staged approach included the following: (a) The covered stent prevented both acute myocardial infarction and progressive pseudoaneurysm expansion in the acute phase. (b) Deferred surgery was rendered technically less hazardous while avoiding the undesirable option of having to exclude an extremely calcified dominant right coronary artery. The patient made an excellent postoperative recovery with complete resolution of her symptoms at 6 weeks' follow-up.
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46
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Khoshbin E, Sogliani F, Tang A. Staged Hybrid Treatment for Contained Rupture of a Large Right Coronary Artery Aneurysm. INNOVATIONS-TECHNOLOGY AND TECHNIQUES IN CARDIOTHORACIC AND VASCULAR SURGERY 2014. [DOI: 10.1177/155698451400900113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Espeed Khoshbin
- Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Victoria Hospital, Blackpool, UK
| | - Franco Sogliani
- Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Victoria Hospital, Blackpool, UK
| | - Augustine Tang
- Department of Cardiothoracic Surgery, Lancashire Cardiac Centre, Victoria Hospital, Blackpool, UK
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47
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A giant coronary artery aneurysm with a fistula followed-up for 12 years using the contrast-enhanced computed tomography scan. Cardiovasc Interv Ther 2013; 29:288-91. [PMID: 24318790 DOI: 10.1007/s12928-013-0231-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 11/25/2013] [Indexed: 10/25/2022]
Abstract
We report a case of a 35-year-old woman who was diagnosed with a giant coronary artery aneurysm (CAA) with a fistula and followed-up using the contrast-enhanced computed tomography scan and 2-dimensional transthoracic echocardiography. The diameter and volume cubic content of the giant CAA had increased linearly during the 12-year follow-up period without any complications. As there are few reports about long-term follow-up of giant CAAs without a surgical intervention, the natural course of a giant CAA is still unclear. Thus, we may need to closely follow-up chronological changes of a giant CAA to decide the treatment strategy.
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48
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Bajaj R, Mamidala S, Bajaj P, Kumar D. Non-atherosclerotic multiple coronary artery aneurysms. BMJ Case Rep 2013; 2013:bcr2013200553. [PMID: 24197810 PMCID: PMC3830186 DOI: 10.1136/bcr-2013-200553] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 52-year-old man underwent two-dimensional echocardiogram which showed moderate to severe aortic regurgitation (AR) and dilated ascending aorta. CT angiography (CTA) showed dilated ascending aorta (5 cm) and transoesophageal echocardiogram revealed bicuspid aortic valve. He underwent cardiac catheterisation which revealed triple vessel aneurysmal disease of the left anterior descending, left circumflex and right coronary artery. The patient underwent aortic graft placement for ascending aortic aneurysm and aortic valve replacement with a Saint Jude valve for severe AR. There was no history or stigmata of Kawasaki disease and workup for coronary artery aneurysm including vasculitis and connective tissue disorders was negative. Histopathology did not reveal evidence of active aortitis or dissection. His aneurysms are being observed by a yearly coronary CTA. We present a rare case of multiple coronary artery aneurysms associated with bicuspid aortic valve and ascending aortic aneurysm.
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Affiliation(s)
- Rishi Bajaj
- Division of Cardiology, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Suresh Mamidala
- Division of Cardiology, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Prabhjot Bajaj
- Department of Internal Medicine, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA
| | - Deepti Kumar
- Division of Cardiology, University of Massachusetts Medical School, Saint Vincent Hospital, Worcester, Massachusetts, USA
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49
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Daralammouri Y, Fuhrmann J, Kunze T. Giant right coronary artery aneurysm with a huge intramural thrombus. J Thorac Cardiovasc Surg 2013; 146:1290-1. [DOI: 10.1016/j.jtcvs.2013.02.065] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 02/16/2013] [Accepted: 02/27/2013] [Indexed: 10/27/2022]
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50
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Avgerinos DV, Salemi A. Surgical management of multiple coronary artery aneurysms. J Card Surg 2013; 28:383-5. [PMID: 23594117 DOI: 10.1111/jocs.12105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
We describe the surgical management of three distinct coronary artery aneurysms in conjunction with coronary artery bypass grafting.
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Affiliation(s)
- Dimitrios V Avgerinos
- Department of Cardiothoracic Surgery, New York Presbyterian - Weill Cornell Medical Center, New York, New York 10065, USA.
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