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Coronary artery aneurysm: case report

Jeffrey E Everett1, Harold M Burkhart

  • 1Division of Cardiothoracic Surgery, University of Tennessee Medical Center, 1940 Alcoa Highway, Suite E-260, Knoxville, Tennessee 37920, USA. jeverett@utmck.edu

Journal of Cardiothoracic Surgery
|January 26, 2008
PubMed

Insights

Atherosclerotic aneurysms of the left main coronary artery are rare but can cause myocardial ischemia. Surgical exclusion and revascularization are effective treatments for these rare coronary artery aneurysms.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Left main coronary artery aneurysms are rare, occurring in 0.1% of angiographic series, often due to atherosclerosis.
  • Other causes include connective tissue disorders, trauma, vasculitis, and congenital factors.

Observation:

  • A 66-year-old man presented with a 2x2 cm saccular aneurysm of the distal left main coronary artery, calcification, and mild stenosis.
  • The patient experienced a non-ST elevation myocardial infarction following surgery for a ruptured appendix.

Findings:

  • Surgical resection and oversewing of the aneurysm were performed, followed by coronary artery bypass grafting.
  • Pathology confirmed an atheromatous coronary artery aneurysm.

Implications:

  • Left main coronary artery aneurysms are primarily atherosclerotic and present with myocardial ischemia due to embolism.
  • Surgical exclusion and revascularization represent the optimal treatment strategy for these rare aneurysms.
Abstract

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