Related Experiment Videos
Saccular aneurysm in the left main coronary artery
S Higashi1, C Enoki, T Matsubara
1Department of Cardiovascular Surgery, Shizuoka Red Cross Hospital, 8-2 Ootemachi, Shizuoka 420-0853, Japan.
The Japanese Journal of Thoracic and Cardiovascular Surgery : Official Publication of the Japanese Association for Thoracic Surgery = Nihon Kyobu Geka Gakkai Zasshi
|March 10, 2001
Summary
This study reports a rare case of left main coronary artery aneurysm in an elderly patient, complicated by coronary stenosis. The aneurysm, likely due to metabolic issues, required surgical intervention and bypass grafting.
Area of Science:
- Cardiology
- Vascular Biology
- Pathology
Background:
- Coronary artery aneurysms (CAAs) are uncommon vascular abnormalities.
- In elderly patients with coronary stenosis, CAAs are typically associated with arteriosclerosis.
- Left main coronary artery aneurysms are particularly rare and pose significant clinical challenges.
Observation:
- A 70-year-old male presented with chest pain and was diagnosed with an 11 mm saccular aneurysm at the left main coronary artery bifurcation.
- The patient also had triple vessel disease, and the aneurysm wall was noted to be thin, indicating a high risk of rupture.
- Surgical intervention involved blocking blood flow to the aneurysm and performing coronary artery bypass grafting.
Findings:
- Pathological examination of the aneurysmal wall revealed no atherosclerotic or inflammatory changes.
- Acidic mucopolysaccharides were detected in the tunica media of the aneurysm.
- This finding suggests a non-atherosclerotic etiology, potentially related to metabolic abnormalities.
Implications:
- This case highlights a rare instance of a left main coronary artery aneurysm in an elderly patient with coronary stenosis, not attributable to arteriosclerosis.
- The presence of acidic mucopolysaccharides suggests a potential metabolic abnormality in smooth muscle cells as the underlying cause.
- Further research into metabolic derangements may offer new insights into the pathogenesis and treatment of coronary aneurysms.