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Percutaneous Closure of a Fistulous Giant Coronary Aneurysm

Gonçalo Pestana1, Vânia Ribeiro1, Carla Sousa2

  • 1Cardiology Department, Centro Hospitalar São João, Porto, Portugal.

The Canadian Journal of Cardiology
|April 30, 2018
PubMed

Insights

Giant coronary artery aneurysms, rare and dangerous, can now be treated with a novel minimally invasive technique. This approach successfully closed a large aneurysm using a device typically for atrial septal defects, preventing rupture.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Giant coronary artery aneurysms (>50 mm) are rare cardiovascular conditions.
  • These aneurysms carry a high risk of rupture and severe complications.
  • Standard treatment involves surgical exclusion, which is invasive.

Observation:

  • A 60-year-old patient presented with a giant proximal right coronary artery aneurysm (70 x 62 mm).
  • The aneurysm was found to be fistulizing into the right atrium.
  • The patient had a history of surgical closure for an ostium secundum atrial septal defect.

Findings:

  • A percutaneous approach was used to close the aortic origin of the aneurysm.
  • An atrial septal occluder device was successfully deployed.
  • Angiography and echocardiogram confirmed successful thrombosis of the aneurysm.

Implications:

  • This case demonstrates an innovative, minimally invasive alternative to surgery for giant coronary aneurysms.
  • Percutaneous closure offers a potentially safer and less invasive treatment option.
  • This technique may be applicable to select cases of complex coronary artery fistulas and aneurysms.

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