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Surgical Management of a Ruptured Giant Left Main Coronary Artery Aneurysm Presenting with Cardiac Tamponade

Dmitriy Shumakov1, Dmitriy Zybin1, Elena Stepanova1

  • 1M.F. Vladimirsky Moscow Regional Clinical Research Institute, Schepkina St. 61/2, 129110 Moscow, Russia.

Diagnostics (Basel, Switzerland)
|September 27, 2025
PubMed

Insights

Giant coronary artery aneurysms (CAAs) are rare but dangerous. This case shows emergency surgery and rapid imaging are crucial for survival in ruptured giant left main coronary artery aneurysms.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Coronary artery aneurysms (CAAs) are uncommon vascular abnormalities.
  • Rupture of giant left main coronary artery (LMCA) aneurysms is a rare, life-threatening emergency.
  • These aneurysms present significant diagnostic and therapeutic challenges.

Purpose of the Study:

  • To report a case of a ruptured giant LMCA aneurysm.
  • To emphasize the role of multimodal imaging in diagnosis.
  • To demonstrate the feasibility of emergency surgical management.

Main Methods:

  • Coronary angiography for initial diagnosis.
  • Contrast-enhanced multidetector computed tomography (MDCT) and echocardiography for confirmation.
  • Emergency surgical intervention including aneurysm excision, thrombectomy, LMCA ostium ligation, and coronary artery bypass grafting (CABG).

Main Results:

  • Successful diagnosis of a ruptured giant LMCA aneurysm causing cardiac tamponade and multi-organ dysfunction.
  • Emergency surgery achieved favorable outcomes.
  • Patient experienced transient multi-organ dysfunction postoperatively, which resolved.
  • Patient discharged in stable condition.

Conclusions:

  • Rapid multimodal imaging is critical for diagnosing ruptured giant LMCA aneurysms.
  • Emergency surgical intervention is a feasible and effective treatment option.
  • Prompt management can lead to favorable outcomes in this rare condition.

Keywords:
cardiac tamponadecoronary artery bypass graftingcoronary artery rupturegiant coronary artery aneurysm

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