Related Experiment Video
Updated: Jan 28, 2026
Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
Published on: September 8, 2023
Giant coronary aneurysms producing chest pain
Raymond Pfister1, Yalda Sadeghi2, Javier Orrit2
1Department of Cardiac Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland. raymond.pfister@chuv.ch.
Insights
Giant coronary aneurysms (GCAA) are rare, with unclear management. Surgical intervention for GCAA offers a viable option with low operative risk, demonstrating positive outcomes.
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Coronary artery aneurysms (CAA) involve localized dilations exceeding 1.5 times adjacent segments.
- Giant coronary aneurysms (GCAA) are uncommon, particularly on the left side, with atherosclerosis as a suspected primary cause.
- Current management strategies for GCAA remain uncertain.
Observation:
- A 62-year-old male presented with progressive chest pain.
- The patient had multiple coronary artery aneurysms: three on the right coronary artery (RCA), including a giant one, and one on the intermediate branch.
- Intraoperative findings revealed two proximal RCA CAAs (2 cm each), a partially thrombosed distal RCA CAA (6 cm), and an intermediate branch CAA (3 cm).
Findings:
- Surgical resection of the two largest CAAs was performed.
- Two saphenous vein grafts were used for bypass procedures.
- Surgical intervention demonstrated a good outcome with low operative risk.
Implications:
- Surgical management is a viable and effective option for GCAA.
- Conservative or observational approaches for GCAA appear to yield poor results.
- This case highlights successful surgical treatment for complex GCAA.
Background:
Coronary artery aneurysms (CAA) are defined as localized coronary artery dilations more than 1.5 times the diameter of the adjacent segments [1]. Giant coronary aneurysms (GCAA) are unusual and aneurysms on the left side are even rarer. Mechanisms are unclear, but seem predominated by atherosclerosis. Until now, management of giant coronary aneurysm is still unclear.
Case Presentation:
A 62-year-old man, presented a 4-month history of progressive chest pain aggravated by physical CAAs: 3 on the right coronary artery (RCA), including a giant one, and one on the intermediate branch. Intraoperatively, we found two proximal RCA CAAs of 2 cm each, a 6 cm distal RCA CAA partially thrombosed, and a 3 cm CAA on the intermediate branch. The two largest CAAs were resected and two saphenous graft bypasses were performed.
Conclusions:
Treatment options include medical treatment (antiaggregation, anticoagulation), percutaneous coronary angioplasty and surgery. Results of observational or conservative management in the few cases of GCAA described in literature, appear to have poor results. Surgery is a good option with low operative risk, especially in giant coronary aneurysms.
Related Concept Videos
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:24Chest Physiotherapy
Purpose
CPT is primarily used for patients with excessive bronchial secretions who have difficulty clearing...
01:30Aneurysm I: Introduction
01:20Pain
01:21Coronary Circulation
Coronary circulation begins at the base of the aorta, where two main arteries arise—the left and right coronary arteries. These arteries encircle the heart in the coronary sulcus and supply the...