Giant right coronary artery aneurysm
Safa Hoodeshenas1, Nikkole Weber2, Prabhakar Shantha Rajiah2
1Department of Radiology, Mayo Clinic, Rochester, US. Hoodeshenas.Safa@mayo.edu.
The International Journal of Cardiovascular Imaging
|October 9, 2025
Summary
Coronary artery fistulas can cause significant hemodynamic changes, leading to progressive dilation and rare aneurysms, particularly in the right coronary artery.
Area of Science:
- Cardiology
- Vascular Medicine
- Medical Imaging
Background:
- Coronary artery fistulas (CAFs) are abnormal connections between coronary arteries and cardiac chambers or vessels.
- CAFs can lead to altered blood flow dynamics, potentially causing coronary artery dilation and aneurysm formation.
- Giant aneurysms (exceeding 50 mm) are uncommon, with a predilection for the proximal right coronary artery.
Purpose of the Study:
- To investigate the clinical presentation and management of coronary artery fistulas.
- To analyze the factors contributing to the development of coronary artery aneurysms in patients with CAFs.
- To review the literature on exceptionally large coronary artery aneurysms.
Main Methods:
- Literature review of case reports and series focusing on coronary artery fistulas and aneurysms.
- Analysis of hemodynamic alterations associated with different types of coronary artery fistulas.
- Review of imaging modalities used for diagnosing and characterizing coronary artery aneurysms.
Main Results:
- Coronary artery fistulas can cause significant hemodynamic disturbances.
- Progressive dilation and aneurysm development are potential complications of shunting into low-pressure areas.
- Giant aneurysms (>50 mm) are rare, most frequently involving the proximal right coronary artery.
Conclusions:
- Coronary artery fistulas require careful evaluation due to potential hemodynamic consequences.
- Early recognition and management are crucial to prevent complications like aneurysm formation.
- Giant coronary artery aneurysms represent a rare but serious manifestation of coronary artery fistulas.
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