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Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment
18:50

Microsurgical Clip Obliteration of Middle Cerebral Aneurysm Using Intraoperative Flow Assessment

Published on: September 25, 2009

Complete proximal occlusion of all three main coronary arteries complicated with a left main coronary aneurysm: a

Takatoshi Wakeyama1, Hiroshi Ogawa, Akira Takaki

  • 1Division of Cardiology, Tokuyama Central Hospital, Koda-cho 1-1, Shunan, Yamaguchi 745-0822.

Journal of Cardiology
|December 9, 2004
PubMed

Insights

A 68-year-old woman with left main coronary artery aneurysm and 100% obstruction underwent successful surgical revascularization. The aneurysm remained stable, and the patient experienced symptom relief for 5 years.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Left main coronary artery (LMCA) disease is a critical condition requiring prompt intervention.
  • Coronary artery aneurysms, particularly in the LMCA, are rare and pose unique management challenges.

Observation:

  • A 68-year-old female presented with recurrent chest pain due to 100% LMCA obstruction and proximal right coronary artery occlusion.
  • Angiography revealed a saccular aneurysm at the distal LMCA with 90% stenosis, alongside significant native coronary artery disease.

Findings:

  • Emergency surgical revascularization with saphenous vein grafts (SVGs) to multiple coronary arteries was performed.
  • Postoperative angiography demonstrated patent SVGs and a stable LMCA aneurysm (10 x 9 mm) with 90% stenosis.
  • The LMCA aneurysm size remained unchanged at 1-year and 3-year follow-ups.

Implications:

  • Successful surgical revascularization can be achieved in patients with complex LMCA disease and aneurysms.
  • Long-term stability of the LMCA aneurysm and graft patency suggests a favorable prognosis.
  • This case highlights the importance of individualized treatment strategies for LMCA aneurysms.

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