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Microsurgical Creation of Giant Bifurcation Aneurysms in Rabbits for the Evaluation of Endovascular Devices
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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.
Journal of Cardiothoracic Surgery
|March 10, 2019
Summary
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.
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