Giant right coronary artery aneurysm mimicking a right intra-ventricular mass: a case report

Giant coronary artery aneurysm in the atrial septum

A man in his 60s with paroxysmal atrial fibrillation was scheduled for a catheter ablation but was admitted to our department after contrast-enhanced CT showed a large homogeneous right atrial mass (52×52 mm) as well as a dilated right coronary artery (RCA). Coronary artery angiography showed a large fistula from the RCA to the mass in the right atrium. A giant coronary artery aneurysm was suspected and a surgical resection was performed. The mass was attached to the atrial septal wall and was palpated in the right atrium with a feeding artery from the RCA. The final diagnosis was an extremely rare case of giant coronary artery aneurysm originating from the RCA. The surgery was successful, and the patient was discharged 30 days later.

Giant right coronary artery aneurysm in the setting of the acute coronary syndrome: A case report

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.

Treatment approach to coronary aneurysms: percutaneous or surgical?

We have recently read with great interest the article by Teng P et al. entitled “Giant right coronary artery aneurysm mimicking a right intra-ventricular mass: a case report”. We appreciate the authors for their reports describing the treatment of a giant right coronary aneurysm mimicking a right intra-ventricular mass. On the other hand, we believe that there are some major drawbacks that need to be addressed.