Myocardial infarction in a youngster due to giant coronary aneurysm
1Aga Khan University Hospital, Karachi, Pakistan. sajid.dhakam@aku.edu
Insights
A young man with myocardial infarction had a giant coronary aneurysm in his right coronary artery. Covered stents successfully sealed the aneurysm, restoring normal blood flow and leaving the patient asymptomatic.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Giant coronary artery aneurysms are rare and can lead to serious complications like myocardial infarction.
- Optimal management strategies for these complex lesions remain debated.
Abstract:
A 22-year old male presented with acute inferior wall myocardial infarction. Coronary angiogram revealed normal left coronary arteries and a giant coronary aneurysm in right coronary artery (RCA). Primary angioplasty of RCA was performed. Large thrombus burden was retrieved with aspiration device and coronary flow restored. However, despite best efforts some thrombus remained and decision to stent was deferred to a later date. Dimensions of aneurysm on quantitative coronary angiogram were 15 mm in width and 46 mm in length. Two weeks later coronary angiogram revealed normal flow in RCA without any angiographically visible thrombus. PCI was performed with two 3.0 × 28 mm Covered stents, Graft Master (JoStent) deployed across the aneurysm, overlapping each other. This completely sealed the aneurysm and intravascular ultrasound confirmed no leakage through the covered stents. Patient remains asymptomatic 2 months post procedure on triple antiplatelet therapy.
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