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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
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Giant coronary artery aneurysm masquerading as an anterior mediastinal mass

Rachel Deitz1, Olugbenga Okusanya2, Arman Kilic3

  • 1Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, 200 Lothrop Street, Ste C800, Pittsburgh, PA, 15213, USA. deitzrl@upmc.edu.

General Thoracic and Cardiovascular Surgery
|September 8, 2020
PubMed

Insights

A rare 6 cm giant coronary artery aneurysm in a young man was successfully repaired surgically. This case highlights challenges in treating large coronary artery aneurysms when bypass grafting is not feasible.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Coronary artery aneurysms are rare vascular abnormalities.
  • Giant aneurysms are exceptionally uncommon, particularly in young adults.

Observation:

  • A 25-year-old man presented with an incidentally discovered 6 cm giant coronary artery aneurysm.
  • The aneurysm involved the mid left anterior descending artery (LAD).

Findings:

  • Advanced imaging (cardiac MRI, CT angiography) confirmed the aneurysm's size (6.7 × 6.2 × 6.0 cm).
  • Surgical repair involved opening, unroofing, and ligating the aneurysm at the ostium.
  • Preservation of a crucial septal perforator supplying collaterals was a key surgical consideration.

Implications:

  • This case demonstrates a successful surgical strategy for a giant coronary artery aneurysm where bypass grafting was precluded by size.
  • It underscores the importance of multi-modality imaging in diagnosis and surgical planning for complex coronary artery lesions.

Keywords:
Cardiac imagingCoronary artery aneurysmSurgical repair

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