Postangioplasty aneurysm of right coronary artery

Area of Science:

• Cardiology
• Vascular Surgery

Background:

• Coronary artery aneurysms (CAAs) are rare, affecting 0.3%-5.3% of patients.
• The right coronary artery is the most commonly affected vessel (40%-70%).
• Percutaneous coronary angioplasty, particularly with stent implantation, is a known cause of CAAs.

Observation:

• A 70-year-old male presented with a large right coronary artery aneurysm.
• The aneurysm was located at the site of previous drug-eluting stent (DES) insertion.
• The patient had a history of multiple coronary angioplasty procedures.

Findings:

• Surgical correction of the large right coronary artery aneurysm was performed.
• The procedure involved cardiopulmonary bypass, aneurysm incision, and oversewing.
• The posterior descending artery was grafted using the in situ right internal mammary artery.

Implications:

• Treatment for CAAs includes medical, percutaneous, and surgical options.
• Surgical intervention was indicated in this case due to aneurysm size and rupture risk.
• This case underscores the importance of surgical management for complex postangioplasty coronary artery aneurysms.