Ruptured giant right coronary artery aneurysm percutaneously plugged

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Giant coronary artery aneurysms are rare and pose significant risks, especially when ruptured.
• Ruptured coronary aneurysms can lead to life-threatening complications such as shock and hemopericardium.
• Surgical intervention for ruptured coronary aneurysms often carries a very high risk due to patient comorbidities.

Observation:

• A patient presented with chest pain, anterior chest wall ecchymosis, and shock, indicative of a ruptured giant coronary aneurysm.
• The aneurysm was identified as a large, acutely leaking right coronary artery aneurysm.
• The patient was deemed at extremely high risk for conventional surgical repair.

Findings:

• Endovascular management was employed to address the ruptured giant coronary aneurysm.
• The inflow to the leaking aneurysm was successfully occluded using the Amplatzer Vascular Plug device.
• This represents the first reported use of the Amplatzer Vascular Plug for sealing an acutely leaking coronary aneurysm.

Implications:

• Endovascular therapy with devices like the Amplatzer Vascular Plug offers a potentially life-saving alternative for managing ruptured coronary aneurysms in high-risk patients.
• This case expands the armamentarium for interventional cardiologists and vascular surgeons in treating complex coronary artery pathologies.
• Further research is warranted to evaluate the long-term efficacy and safety of this endovascular approach in similar cases.