[Coronary artery aneurysm with various clinical course]

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Medicine

Background:

• Coronary artery aneurysms (CAAs) are abnormal dilations of the coronary arteries.
• While often asymptomatic, CAAs can lead to severe complications if left untreated.

Observation:

• This study presents four cases of patients with symptomatic CAAs.
• Symptoms included effort angina, dyspnea, general fatigue, and acute myocardial infarction.
• Diagnostic methods involved coronary angiography (CAG) and chest computed tomography.

Findings:

• Surgical interventions varied based on aneurysm characteristics, including coronary artery bypass grafting (CABG), patch angioplasty, fistula closure, and saphenous vein grafting.
• One case involved a ruptured CAA with pericardial effusion, necessitating urgent repair.
• Large aneurysms, defined as more than three times the normal diameter, were identified as a critical factor for surgical consideration.

Implications:

• These findings underscore the importance of timely surgical intervention for symptomatic and large coronary artery aneurysms.
• Effective management strategies can prevent life-threatening complications such as myocardial infarction and aneurysm rupture.
• The study highlights the diverse clinical presentations and successful surgical management of coronary artery aneurysms.