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Coronary artery aneurysm: management and association with abdominal aortic aneurysm

Giovanni Mariscalco1, Vittorio Mantovani, Sandro Ferrarese

  • 1Department of Surgical Sciences, Cardiac Surgery Division, Varese University Hospital, 21100 Varese, Italy. giovannimariscalco@yahoo.it

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
|March 15, 2006
PubMed

Insights

Surgical repair of coronary artery aneurysms (CAA) is effective, with most patients remaining asymptomatic. Screening for abdominal aortic aneurysms (AAA) is recommended due to their frequent association with CAA.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery aneurysm (CAA) is defined as a dilatation exceeding 1.5 times the adjacent normal coronary artery diameter.
  • Pathogenetic mechanisms of CAA are thought to be similar to those of abdominal aortic aneurysms (AAA).
  • Surgical intervention for CAA is indicated when the aneurysm is 3-4 times larger than the original vessel diameter.

Purpose of the Study:

  • To review surgical treatment experience for coronary artery aneurysms (CAA).
  • To analyze the association between coronary artery aneurysms (CAA) and abdominal aortic aneurysms (AAA).

Main Methods:

  • Eleven patients (9 men, mean age 66) underwent surgery for CAA between 1993 and 2005.
  • Coronary aneurysms were incidentally diagnosed via coronary angiography.
  • Surgical technique involved longitudinal incision, suturing of openings, obliteration of sacs, retrograde cardioplegia, and coronary artery bypass grafting distal to the aneurysm.

Main Results:

  • One patient died early post-operatively due to respiratory failure; the remaining 10 patients were alive and asymptomatic at a median follow-up of 76 months.
  • No recurrent angina or myocardial infarction was observed in the surviving patients.
  • Six patients underwent surgical repair or endoprosthesis implantation for abdominal aortic aneurysms (AAA).

Conclusions:

  • The employed surgical techniques for CAA provided durable outcomes.
  • Routine screening for abdominal aortic aneurysms (AAA) is recommended in patients with coronary artery aneurysms (CAA) due to their shared pathogenetic mechanisms.
Abstract

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