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Surgical treatment of a giant left main aneurysm

Laura Viola1, Luther Keita2, Dave Veerasingam2

  • 1Department of Cardiothoracic Surgery, University Hospital Galway, Galway, Ireland laura.viola.md@gmail.com.

Interactive Cardiovascular and Thoracic Surgery
|September 15, 2016
PubMed

Insights

Giant coronary artery aneurysms are rare, with no standard treatment. This case details a successful surgical approach for a 75-year-old man with a giant left main aneurysm, involving ligation and bypass grafting.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms (CAAs) are uncommon vascular abnormalities.
  • Giant CAAs, defined as >1.5 times the adjacent artery diameter, lack established treatment guidelines.

Observation:

  • A 75-year-old male presented with worsening exertional chest pain over six months.
  • Diagnostic imaging revealed a giant aneurysm of the left main coronary artery.

Findings:

  • The patient underwent surgical ligation of the proximal left anterior descending artery and first diagonal branch.
  • A triple coronary artery bypass graft using a saphenous vein was performed to revascularize the circumflex, left anterior descending, and first diagonal arteries.

Implications:

  • This case demonstrates a viable surgical strategy for managing complex giant left main coronary artery aneurysms.
  • Successful revascularization offers a potential treatment pathway for this rare and challenging condition.

Keywords:
Cardiac surgeryGiant coronary aneurysmLeft main

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