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Surgical treatment of coronary artery aneurysms
Erik Beckmann1, Saad Rustum1, Steffen Marquardt2
1Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Insights
Surgical treatment for coronary artery aneurysms (CAA) in 15 patients showed zero in-hospital mortality. Follow-up revealed excellent long-term outcomes with only one re-intervention needed.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Interventional Cardiology
Background:
- Coronary artery aneurysms (CAA) are rare cardiovascular conditions.
- Surgical intervention is a potential treatment modality for CAAs.
Purpose of the Study:
- To present surgical treatment experience in patients with coronary artery aneurysms.
- To evaluate the short- and long-term outcomes of surgical CAA management.
Main Methods:
- A retrospective review of 15 patients who underwent surgery for CAA between March 2000 and October 2016.
- Surgical techniques included bypass grafting (total arterial or venous/internal thoracic artery) and resection/ligation of aneurysms.
- Data collected included patient demographics, aneurysm characteristics, surgical details, and clinical outcomes.
Main Results:
- The mean patient age was 60 ± 16 years, with 47% males. Underlying conditions included Kawasaki syndrome (13%) and Marfan syndrome (7%).
- Isolated CAAs occurred in 73% of patients, affecting various coronary arteries. The majority (93%) underwent surgery on cardiopulmonary bypass.
- In-hospital mortality was 0%. Follow-up (80 patient-years) showed only one patient (7%) requiring re-intervention, indicating good long-term results.
Conclusions:
- Surgical treatment of coronary artery aneurysms is associated with favorable short-term outcomes, including no in-hospital mortality.
- The study demonstrates good long-term results following surgical intervention for CAA, with a low rate of re-intervention.
Introduction:
Coronary artery aneurysms (CAA) are rare. We present our experience with the surgical treatment of patients with CAAs.
Methods:
Between March 2000 and October 2016, 15 patients with CAA underwent surgery.
Results:
Mean age of patients was 60 ± 16 years and 47% (n = 7) were male. Kawasaki syndrome was present in two (13%) patients and 7% (n = 1) patients had Marfan syndrome. Isolated CAAs were found in 73% (n = 11) and involvement of multiple vessels was present in 27% (n = 4) of patients. Coronary arteries (CA) affected by aneurysms were: 19% (n = 4) left main stem, 33% (n = 7) left anterior descending, 14% (n = 3) left circumflex, and 33% (n = 7) right coronary artery. The majority of patients (93%, n = 14) were operated on pump with a mean cross-clamp time of 51 ± 23 min. 53% (n = 8) of patients received total arterial CA bypass grafting, while the remaining patients (47%, n = 7) received venous ± internal thoracic artery grafts. Resection/ligation of CAA was performed in 27% (n = 4) of patients. In-hospital mortality was 0% (n = 0). Follow-up was complete for 100% of patients and comprised a total of 80 patient-years. During follow-up, only one patient (7%) required re-intervention.
Conclusion:
Surgical treatment of CAA has good short- and long-term results.