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Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
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Left Main Coronary Artery Aneurysm

Hossein Doustkami1, Nasrollah Maleki1, Zahra Tavosi2

  • 1Imam Khomeini Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.

The Journal of Tehran Heart Center
|July 13, 2016
PubMed

Insights

Left main coronary artery aneurysms are rare but can be caused by atherosclerosis. Surgical intervention, like bypass grafting, can effectively treat these aneurysms, leading to asymptomatic recovery.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Left main coronary artery aneurysms are rare, found in 0.1% of patients undergoing angiography.
  • Atherosclerosis is the primary cause of coronary artery aneurysms.
  • Diagnosis and treatment rely on angiography, with management tailored to coronary stenosis severity.

Observation:

  • A 72-year-old male with hypertension presented with unstable angina.
  • Electrocardiogram revealed ST depression and T-wave inversion.
  • Echocardiography showed reduced ejection fraction (45%) and regional wall motion abnormalities.

Findings:

  • Coronary angiography confirmed a saccular left main coronary artery aneurysm.
  • Significant stenosis was noted in the left anterior descending, left circumflex, and right coronary arteries.
  • The patient underwent successful coronary artery bypass grafting and aneurysm ligation.

Implications:

  • Surgical management of left main coronary artery aneurysms with concomitant stenosis can yield positive outcomes.
  • This case highlights the importance of prompt diagnosis and intervention for rare coronary artery pathologies.
  • Successful surgical treatment resulted in complete symptom resolution at six-month follow-up.

Keywords:
AneurysmCoronary angiographyCoronary vessels

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