Giant coronary aneurysms producing chest pain.
Coronary bypass
Coronary ectasia
Giant coronary aneurysm
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
08 Mar 2019
08 Mar 2019
Historique:
received:
13
01
2019
accepted:
20
02
2019
entrez:
10
3
2019
pubmed:
10
3
2019
medline:
14
3
2019
Statut:
epublish
Résumé
Coronary artery aneurysms (CAA) are defined as localized coronary artery dilations more than 1.5 times the diameter of the adjacent segments [1]. Giant coronary aneurysms (GCAA) are unusual and aneurysms on the left side are even rarer. Mechanisms are unclear, but seem predominated by atherosclerosis. Until now, management of giant coronary aneurysm is still unclear. A 62-year-old man, presented a 4-month history of progressive chest pain aggravated by physical CAAs: 3 on the right coronary artery (RCA), including a giant one, and one on the intermediate branch. Intraoperatively, we found two proximal RCA CAAs of 2 cm each, a 6 cm distal RCA CAA partially thrombosed, and a 3 cm CAA on the intermediate branch. The two largest CAAs were resected and two saphenous graft bypasses were performed. Treatment options include medical treatment (antiaggregation, anticoagulation), percutaneous coronary angioplasty and surgery. Results of observational or conservative management in the few cases of GCAA described in literature, appear to have poor results. Surgery is a good option with low operative risk, especially in giant coronary aneurysms.
Sections du résumé
BACKGROUND
BACKGROUND
Coronary artery aneurysms (CAA) are defined as localized coronary artery dilations more than 1.5 times the diameter of the adjacent segments [1]. Giant coronary aneurysms (GCAA) are unusual and aneurysms on the left side are even rarer. Mechanisms are unclear, but seem predominated by atherosclerosis. Until now, management of giant coronary aneurysm is still unclear.
CASE PRESENTATION
METHODS
A 62-year-old man, presented a 4-month history of progressive chest pain aggravated by physical CAAs: 3 on the right coronary artery (RCA), including a giant one, and one on the intermediate branch. Intraoperatively, we found two proximal RCA CAAs of 2 cm each, a 6 cm distal RCA CAA partially thrombosed, and a 3 cm CAA on the intermediate branch. The two largest CAAs were resected and two saphenous graft bypasses were performed.
CONCLUSIONS
CONCLUSIONS
Treatment options include medical treatment (antiaggregation, anticoagulation), percutaneous coronary angioplasty and surgery. Results of observational or conservative management in the few cases of GCAA described in literature, appear to have poor results. Surgery is a good option with low operative risk, especially in giant coronary aneurysms.
Identifiants
pubmed: 30850000
doi: 10.1186/s13019-019-0872-4
pii: 10.1186/s13019-019-0872-4
pmc: PMC6407226
doi:
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
52Références
Am J Cardiol. 2004 Jun 15;93(12):1549-51
pubmed: 15194034
Circulation. 2005 Aug 2;112(5):e70-1
pubmed: 16061748
Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):33-6
pubmed: 22505591
J Invasive Cardiol. 2012 Sep;24(9):465-9
pubmed: 22954568
Prog Cardiovasc Dis. 1997 Jul-Aug;40(1):77-84
pubmed: 9247557