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Bilateral arteriosclerotic coronary arterial aneurysms successfully treated with saphenous vein bypass grafting
Insights
This study reports a rare case of bilateral coronary artery aneurysms in a patient with ischemic heart disease. Successful treatment was achieved using saphenous vein grafting, highlighting a unique presentation with proximal luminal stenosis.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery aneurysms are rare vascular abnormalities.
- Bilateral involvement is exceptionally uncommon.
- Ischemic heart disease can coexist with coronary artery aneurysms.
Purpose of the Study:
- To describe a unique case of bilateral coronary arterial aneurysms.
- To report the successful surgical management of this condition.
- To discuss the potential role of poststenotic dilatation in etiology.
Main Methods:
- Diagnosis via preoperative coronary arteriography.
- Surgical intervention using saphenous vein grafting.
- Intraoperative assessment of coronary artery anatomy.
Main Results:
- Successful treatment of bilateral coronary arterial aneurysms with saphenous vein grafting.
- Identification of proximal luminal stenosis in the left anterior descending artery aneurysm.
- The right coronary artery was found to be aneurysmal and proximally occluded.
Conclusions:
- Saphenous vein grafting is an effective treatment for bilateral coronary artery aneurysms.
- This case is the 14th reported instance of nonfistulous coronary artery aneurysm diagnosed in vivo.
- The association with proximal luminal stenosis is novel, suggesting poststenotic dilatation as a potential factor.
Abstract:
A man with ischemic heart disease was discovered to have bilateral coronary arterial aneurysms that were sucessfully treated with saphenous vein grafting. Preoperative coronary arteriograms revealed a tight luminal stenosis at the proximal end of the large aneurysm in the left anterior descending artery, suggesting poststenotic dilatation as an etiologic or contributing factor. The right coronary artery was totally occluded proximally, but was noted to be aneurysmal at operation. This is the 14th published case of nonfistulous coronary arterial aneurysm diagnosed in vivo, and the first associated with proximal luminal stenosis.