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Giant coronary artery aneurysm complicated with aortic regurgitation

Kazunobu Hirooka1, Taijyu Watanabe, Masahiro Ohnuki

  • 1Department of Cardiovascular Surgery, Tsuchiura Kyodo General Hospital, Ibaraki, Japan. khiro@bc4.so-net.ne.jp

The Annals of Thoracic Surgery
|February 24, 2009
PubMed

Insights

This rare case details a 12 cm giant coronary artery aneurysm alongside severe aortic insufficiency. Surgical repair involved aortic valve replacement and coronary artery bypass grafting.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Aortic insufficiency and coronary artery aneurysms are significant cardiovascular conditions.
  • Giant coronary artery aneurysms are exceedingly rare, posing complex management challenges.

Observation:

  • A patient presented with grade III aortic insufficiency and a massive 12 cm coronary artery aneurysm.
  • The aneurysm was thrombosed and directly communicated with the aorta via the left coronary ostium.

Findings:

  • Surgical findings included an incompetent bicuspid aortic valve and the giant thrombosed aneurysm.
  • Successful surgical intervention involved direct closure of the coronary ostium, left anterior descending artery revascularization with a saphenous vein graft, and mechanical aortic valve replacement.

Implications:

  • This case highlights successful surgical strategies for managing complex, co-existing aortic valve disease and giant coronary aneurysms.
  • Effective treatment requires a multidisciplinary approach, combining valve repair/replacement with coronary revascularization.

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