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Surgical management of multiple coronary artery aneurysms, including the giant form

Sebastian Holinski1, Pascal Maria Dohmen, Alexander Lembcke

  • 1Departments of Cardiovascular Surgery, Charité Hospital, Medical University, 10117 Berlin, Germany. sebastian.holinski@charite.de

Texas Heart Institute Journal
|July 2, 2009
PubMed

Insights

Giant coronary artery aneurysms require individualized surgical management. This case report details successful surgical repair of multiple complex coronary artery aneurysms, including a giant 65mm right coronary artery aneurysm.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Interventional Cardiology

Background:

  • Coronary artery aneurysms (CAAs) pose risks like thromboembolism and rupture.
  • Giant CAAs (>20 mm) are rare, with undefined surgical treatment strategies.
  • Standardized surgical management for CAAs is lacking, necessitating personalized approaches.

Observation:

  • A 63-year-old male presented with multiple CAAs, including a 65mm aneurysm of the right coronary artery (RCA) and two aneurysms of the circumflex artery.
  • Diagnostic imaging included transesophageal echocardiography, MRI, and coronary angiography.
  • The giant RCA aneurysm caused compression of the right atrium and ventricle.

Findings:

  • Successful surgical intervention involved partial resection and saphenous vein grafting for the giant RCA aneurysm.
  • Smaller circumflex artery aneurysms were managed with suture ligation and left internal mammary artery bypass grafting.
  • The patient underwent successful treatment with a tailored surgical strategy.

Implications:

  • This case highlights the feasibility of individualized surgical techniques for complex and giant coronary artery aneurysms.
  • Tailored surgical approaches can achieve favorable outcomes in rare and challenging CAA cases.
  • Further research into standardized yet adaptable surgical guidelines for CAAs is warranted.

Keywords:
Coronary aneurysm/diagnosis/etiology/surgerycoronary artery disease/complicationscoronary thrombosis/complications

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