Related Experiment Video

Updated: Sep 16, 2025

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA
13:10

Direct Re-implantation of Left Coronary Artery into the Aorta in Adults with Anomalous Origin of Left Coronary Artery from the Pulmonary Artery ALCAPA

Published on: April 24, 2017

18.7K

Multiple Giant Coronary Artery Aneurysms With a Coronary Pulmonary Artery Fistula: A Case Report

Yosuke Motoharu1, Satoru Arai2, Ryuji Hojo3

  • 1Cardiothoracic Surgery, Fukuoka Wajiro Hospital, Fukuoka, JPN.

Cureus
|July 7, 2025
PubMed

Insights

This study presents a successful surgical treatment for multiple giant coronary artery aneurysms and a fistula in an elderly patient. The innovative beating heart technique avoided the need for coronary artery bypass grafting.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery aneurysms (CAAs) are uncommon vascular abnormalities.
  • Giant CAAs, defined as exceeding 2 cm, present unique surgical challenges.
  • Coronary artery fistulas further complicate management.

Observation:

  • An 82-year-old female presented with multiple CAAs and a coronary-to-pulmonary artery fistula.
  • Diagnostic imaging revealed four aneurysms (10-45 mm) in the RCA, LAD, and LCx arteries.
  • A Qp/Qs ratio of 1.34 indicated significant fistula flow.

Findings:

  • Surgical repair was performed using median sternotomy and cardiopulmonary bypass on a beating heart.
  • Large aneurysms of the RCA (30 mm) and LAD (45 mm) were directly managed.
  • Feeding vessels were ligated, aneurysms were opened and sutured, and the fistula was closed successfully without revascularization.

Implications:

  • This case demonstrates the feasibility of treating complex multiple giant CAAs and fistulas with a beating heart technique.
  • Successful management without revascularization highlights a potentially less invasive surgical option.
  • The findings suggest that careful surgical planning can achieve excellent outcomes in rare CAA cases.

Keywords:
cardiopulmonary bypasscoronary artery fistulagiant coronary artery aneurysmmedian sternotomyon pump beating

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