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Updated: Mar 15, 2026

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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From Small Coronary Artery Aneurysm to Giant Left Ventricle Aneurysm

Sergio Sciacca1, Giuseppe Maria Raffa, Giovanni Gentile

  • 1Cardiac Surgery and Heart Transplantation Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy.

Medical Principles and Practice : International Journal of the Kuwait University, Health Science Centre
|September 8, 2016
PubMed

Insights

Treatment of coronary artery aneurysms (CAA) is complex, even with percutaneous methods. This case highlights challenges and the need for guidelines in managing these rare cardiovascular conditions.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Aneurysm Research

Background:

  • Coronary artery aneurysms (CAA) present unique therapeutic challenges.
  • Limited consensus guidelines exist for managing CAA.
  • Focused registries are needed to inform treatment strategies.

Observation:

  • A 58-year-old male with acute coronary syndrome underwent stent placement for a right coronary artery aneurysm.
  • The procedure led to acute myocardial infarction.
  • Subsequent left ventricular remodeling and ventricular tachycardia necessitated surgical intervention.

Findings:

  • Percutaneous treatment of CAA is technically demanding, even in high-volume centers.
  • Undersizing a covered stent resulted in migration and severe complications.
  • The optimal therapeutic strategy for CAA remains controversial.

Implications:

  • "Heart team"-based decision-making is recommended for CAA management.
  • Case reports underscore the complexity and potential pitfalls of percutaneous CAA treatment.
  • Further research and guideline development are crucial for improving patient outcomes.
Abstract

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