Abstract
We report two cases of coronary artery aneurysm including one case of the left main coronary artery aneurysm. The coronary angiogram of one patient, a 68-year-old male, having anterior chest pain on exertion, revealed left anterior descending coronary artery (segment 6) aneurysm of 7 mm in diameter with 90% stenosis distal to the aneurysm and 75% stenosis in the right coronary artery (segment 2). The coronary angiogram of another patient, a 69-year-old female, having chest pain unrelated to exertion, revealed left main coronary artery aneurysm of 25 mm in diameter and delayed filling of contrast medium into the left anterior descending coronary artery. We decided to operate by the reason of not only significant coronary artery stenosis but risks of myocardial infarction due to embolization inot distal coronary arteries and rupture of the aneurysm. We performed coronary artery bypass graftings using the great saphenous veins and closure of the coronary arteries running into and out the aneurysm under cardiopulmonary bypass. It is recomended that ligation of the coronary arteries connecting to the aneurysm or resection of the aneurysm followed by coronary artery bypass grafting is performed before developing myocardial infarction or rupture of aneurysm.
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Rath S, Har-Zahav Y, Battler A, Agranat O, Rotstein Z, Rabinowitz B, Neufeld HN: Fate of nonobstructive aneurysmatic coronary artery disease. Angiographic and clinical follow-up report. Am Heart J 109: 785–791, 1985
Befeler B, Aranda JM, Embi A, Mullin FL, Ei-Sherif N, Lazzara R: Coronary artery aneurysms. Study of their etiology, clinical course and effect on left ventricular function and prognosis. Am J Med 62: 597–607, 1977
Gray LA Jr, McMartin DE: Surgical treatment of coronary artery aneurysm with rupture into the right atrium. J Thorac Cardiovasc Surg 74: 455–460, 1977
Glickel SZ, Maggs PR, Ellis FH Jr: Coronary artery aneurysm. Ann Thorac Surg 25: 372–376, 1978
LaMendola CL, Culliford AT, Harris LJ, Amendo MT: Multiple aneurysms of the coronary arteries in a patient with systemic aneurysmal disease. Ann Thorac Surg 49: 1009–1010, 1990
John LCH, Hornick P, Davies DW, Banim SO, Rees GM: The role of surgery in the management of solitary coronary artery aneurysm. Eur J Cardio Thorac Surg 5: 440–441, 1991
Eid GA, Lang-Lazdunski L, Hvass U, Pansard Y, Belmatoug N, Faraggi M, Paillole C, Langlois J: Management of giant coronary artery aneurysm with fistulization into the right atrium. Ann Thorac Surg 56: 372–374, 1993
Westaby S, Drossos G, Giannopoulos N: Posttraumatic coronary artery aneurysm. Ann Thorac Surg 60: 712–713, 1995
Lepojärvi M, Salmela E, Huikuri H, Kärkölä P: Repair of an aneurysm of the left main coronary artery. Ann Thorac Surg 61: 1247–1249, 1996
Biglioli P, Alamanni F, Antona C, Agrifoglio M, Spirito R: Aneurysms of the coronary arteries. One case report. Thorac Cardiovasc Surgeon 36: 239–240, 1988
Bricker DL, Rittmann DV Jr: Arteriosclerotic aneurysms of the coronary arteries. Surgical treatment. Texas Heart Institute J 14: 23–30, 1978
Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, Mudd JG, Gosselin AJ: Aneurysmal coronary artery disease. Circulation 67: 134–138, 1983
Oliveros RA, Falsetti HL, Carroll RJ, Heinle RA, Ryan GF: Atherosclerotic coronary artery aneurysm. Report of five cases and review of literature. Arch Intern Med 134: 1072–1076, 1974
Markis JE, Joffe CD, Cohn PF, Feen DJ, Herman MV, Gorlin R: Clinical significance of coronary arterial ectasia. Am J Cardiol 37: 217–222, 1976
Falsetti HL, Carroll RJ: Coronary artery aneurysm. A review of the literature with a report of 11 new cases. Chest 69: 630–636, 1976
Alford WC Jr, Stoney WS, Burrus GR, Frist RA, Thomas CS Jr: Recognition and operative management of patients with arteriosclerotic coronary artery aneurysms. Ann Thorac Surg 22: 317–321, 1976
Aintablian A, Hamby RI, Hoffman I, Kramer RJ: Coronary ectasia. Incidence and results of coronary bypass surgery. Am Heart J 96: 309–315, 1978
Topaz O, DiSciascio G, Cowley MJ, Goudreau E, Soffer A, Nath A, Lanter P, Vetrovec GW: Angiographic features of left main coronary artery aneurysms. Am J Cardiol 67: 1139–1142, 1991
Baroldi G: Disease of extramural coronary arteries. Aneurysm of coronary arteries. Cardiovascular Pathology. Vol. 1, second ed. Silver MD, ed., New York, 1991, Churchill Livingstone, Inc., p541–544
Kitamura S, Kawashima Y, Miyamoto K, Kobayashi T, Matsuda H, Ohgitani N, Kodama K, Minamino T, Manabe H: Multiple coronary artery aneurysms resulting in myocardial infarction in a young man. Treatment by double aortacoronary saphenous vein bypass grafting. J Thorac Cardiovasc Surg 70: 290–297, 1975
3. 39: 474–479, 1991
PTCA CABG 1. 35: 872–875, 1987
PTCA 1. 40: 1738–1743, 1992
PTCA 1. 47: 303–306, 1994
Tibbits P, Stanton K, Ashworth H, Baker W: Congenital coronary aneurysms nine years following saphenous vein bypass graft surgery. Ann Thorac Surg 32: 411–414, 1981
1. 39: 1825–1830, 1991
Morshuis WJ, Noyez L, Skotnicki SH, Lacquet LK: Surgical treatment of an isolated coronary artery aneurysm. An alternative approach. J Thorac Cardiovasc Surg 101: 369–371, 1991
Mattern AL, Baker WP, McHale JJ, Lee DE: Congenital coronary aneurysms with angina pectoris and myocardial infarction treated with saphenous vein bypass graft. Am J Cardiol 30: 906–909, 1972
Hearne SF, Holmes DR Jr, Pluth JR, Lie JT: False aneurysm of the left coronary artery. J Thorac Cardiovasc Surg 82: 915–921, 1981
Moses HW, Huddle RA Jr, Nanda NC, Stewart S, Schreiner BF Jr: Surgical management of an aneurysm of the left main coronary artery. Ann Thorac Surg 27: 569–573, 1979
Vijayanagar R, Shafii E, DeSantis M, Waters RS, Desai A: Surgical treatment of coronary aneurysms with and without rupture. J Thorac Cardiovasc Surg 107: 1532–1535, 1994
Wan S, LeClerc JL, Vachiery JL, Vincent JL: Cardiac tamponade due to spontaneous rupture of right coronary artery aneurysm. Ann Thorac Surg 62: 575–576, 1996
19: 281–284, 1966
1. 33: 2245–2248, 1985
1. 46: 164–167, 1993
1. 46: 714–716, 1993
1. 41: 2229–2233, 1993
1. 42: 497–499, 1994
Liberthson RR, Sagar K, Berkoben JP, Weintraub RM, Levine FH: Congenital coronary arteriovenous fistula. Report of 13 patients, review of the literature and delineation of management. Circulation 59: 849–854, 1979
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Nogaki, H., Shioi, K., Mase, T. et al. Two cases of coronary artery aneurysm including one case of the left main coronary artery aneurysm. Jpn J Thorac Caridovasc Surg 46, 513–518 (1998). https://doi.org/10.1007/BF03217783
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DOI: https://doi.org/10.1007/BF03217783