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Superior vena cava syndrome caused by a giant right coronary artery aneurysm

Hagen Kahlbau1, João João Mendes2, Isabel Fragata3

  • 1Department of Cardiac Surgery, Hospital CUF Tejo, Lisbon, Portugal.

Asian Cardiovascular & Thoracic Annals
|February 5, 2025
PubMed

Insights

A giant coronary artery aneurysm caused superior vena cava syndrome in a patient. Emergent surgery and extracorporeal membrane oxygenation (ECMO) successfully relieved the compression and improved the patient's condition.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Case Reports

Background:

  • Superior vena cava syndrome (SVCS) can arise from various thoracic pathologies.
  • Coronary artery aneurysms are rare but can lead to significant complications due to mass effect.

Purpose of the Study:

  • To report a rare case of SVCS caused by a giant right coronary artery aneurysm.
  • To describe the successful management of this complex clinical scenario.

Main Methods:

  • Diagnostic imaging including echocardiography and computed tomography angiography.
  • Emergent cardiac surgery for aneurysm decompression.
  • Post-operative intensive care with veno-arterial extracorporeal membrane oxygenation (VA ECMO).

Main Results:

  • A giant right coronary artery aneurysm was identified as the cause of SVCS.
  • Surgical decompression of the superior vena cava was technically successful.
  • The patient demonstrated hemodynamic improvement and was weaned from VA ECMO within 6 days.

Conclusions:

  • Giant coronary artery aneurysms are a potential, albeit rare, cause of SVCS.
  • Prompt surgical intervention and advanced circulatory support can be life-saving in such critical cases.

Keywords:
CABGapplications)cardiaccardiac anatomy/pathologic anatomycomputed tomographycomputed tomography scanechocardiography (all modalities

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