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DOI: 10.1055/s-0037-1598706
Surgical Treatment of Coronary Artery Aneurysms
Publication History
Publication Date:
03 February 2017 (online)
Introduction: Coronary artery aneurysms (CAA) have a very low prevalence and there is only very limited available literature on this topic. There is no consensus on the treatment of CAA. Here, we present our experience with the surgical treatment of patients with CAA.
Methods: Between 03/2000 and 04/2015, a total of 14 patients with CAA underwent surgery at our center. We conducted a retrospective review with prospective follow-up.
Results: The mean age of patients was 60 ± 16 years and 36% (n = 5) were male. 14% (n = 2) patients had Kawasaki syndrome and 7% (n = 1) subject had Marfan syndrome. Isolated CAAs were found in 71% (n = 10) and involvement of multiple vessels was present in 29% (n = 4) of patients. Coronary arteries (CA) affected by aneurysms were: 18% (n = 3) left main stem, 18% (n = 3) left anterior descending, 18% (n = 3) left circumflex and 47% (n = 8) right coronary artery. The mean diameter of the CAAs was 1.9 (range: 0.5 to 7) cm. The majority of patients (93%, n = 13) were operated on pump with a mean cross-clamp time of 51 ± 24 minutes. 50% (n = 7) of patients received total arterial CA bypass grafting, while the remaining patients (50%, n = 7) received venous ± internal thoracic artery grafts. Resection/ligation of CAA was performed in 29% (n = 4) of patients. In-hospital mortality was 0%. During follow up, only 1 patient (7%) required re-intervention (percutaneous stent placement) due to bypass closure.
Discussion: Our data indicates that most CAAs are located in the right coronary artery. We conclude that surgical treatment of CAAs is safe and yields acceptable short- and long-term results.