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Surgical management of multiple giant coronary artery aneurysms determining myocardial ischemia

Andrea Garatti1, Andrea Daprati1, Guglielmo Saitto1

  • 1Department of Cardiovascular Disease "E. Malan", Cardiac Surgery Unit, IRCCS Policlinico S. Donato Hospital, Milan, Italy.

Journal of Cardiac Surgery
|October 11, 2019
PubMed

Insights

Coronary artery aneurysms (CAAs) are rare, and their management is unclear. This study shows coronary artery bypass grafting with ligation effectively excludes giant CAAs, offering a viable surgical solution.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms (CAAs) are uncommon vascular lesions with undefined optimal management strategies.
  • Giant CAAs present significant clinical challenges due to their size and potential complications.

Observation:

  • A series of three patients with diffuse symptomatic coronary artery disease and giant CAAs were treated.
  • Aneurysms were located on the circumflex branch (6x5cm), proximal right coronary artery (5x6cm), and proximal left anterior descending (LAD) artery (4x5cm).

Findings:

  • Standard coronary artery bypass grafting, including LIMA-on-LAD and sequential saphenous vein grafts, was performed.
  • Associated exclusion of the CAAs was achieved through proximal and distal ligation, tailored to individual coronary anatomy.

Implications:

  • Surgical exclusion of giant CAAs using coronary artery bypass grafting and ligation is a feasible and effective treatment.
  • This approach successfully excluded aneurysms in all three patients, as confirmed by six-month follow-up CT scans.

Keywords:
CABGcoronary aneurysm

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