Surgical resection of the giant right coronary artery aneurysm

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Surgery

Background:

• A 74-year-old male with prior coronary artery bypass grafting (CABG) presented with multiple aortic aneurysms.
• Imaging revealed distal arch, abdominal aortic aneurysms (AAA), and a giant right coronary artery aneurysm (rCAA).

Observation:

• The giant right coronary artery aneurysm (70 mm diameter) significantly oppressed the right atrium and ventricle.
• The patient underwent initial treatment for aortic aneurysms before addressing the rCAA.

Findings:

• Surgical resection of the giant rCAA was performed, followed by new saphenous vein graft (SVG) coronary artery bypass grafting (CABG) without cardiopulmonary bypass.
• Histopathology confirmed atherosclerotic changes as the etiology of the rCAA.
• Postoperative recovery was favorable, with decompression of cardiac structures and improved tricuspid valve hemodynamics.

Implications:

• This case highlights the successful management of a rare giant coronary artery aneurysm causing significant cardiac compression.
• Surgical intervention can effectively relieve symptoms and improve cardiac function in complex cardiovascular cases.
• Atherosclerotic changes are a key etiological factor in the development of giant coronary artery aneurysms.