Man in his third decade with a giant coronary artery aneurysm

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Updated: Jan 14, 2026

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

19.1K

Weihao Chen1, Cheng Shen2

  • 1West China School of Medicine, West-China Hospital, Sichuan University, Chengdu, 610041, China.

Journal of Cardiothoracic Surgery
|October 17, 2025
PubMed

Insights

A rare giant coronary artery aneurysm (GCAA) in a young male presented with chest pain and hemoptysis. Surgical repair via coronary artery bypass grafting (CABG) led to a successful recovery, highlighting effective management strategies.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Imaging

Background:

  • Giant coronary artery aneurysms (GCAA) are rare, particularly in young adults.
  • Chronic rupture of a GCAA can present with atypical symptoms like hemoptysis.
  • Idiopathic origin and chronic inflammation are potential etiological factors.

Purpose of the Study:

  • To report a unique case of a GCAA with chronic rupture in a 27-year-old male.
  • To emphasize the diagnostic utility of multi-modality imaging in complex coronary pathologies.
  • To illustrate the successful surgical management of GCAA in a young patient.

Main Methods:

  • Detailed clinical presentation including chronic chest pain and acute hemoptysis.
  • Diagnostic imaging using cardiac computed tomography angiography (CTA) and catheter angiography.
  • Comprehensive etiological workup excluding common causes like Kawasaki disease and vasculitis.
  • Surgical intervention involving coronary artery bypass grafting (CABG) and aneurysm resection.

Main Results:

  • A 3.8 cm × 2.5 cm GCAA in the mid-left anterior descending artery (mid-LAD) with adjacent 60% stenosis was identified.
  • Idiopathic origin with chronic inflammatory changes was suspected after extensive negative workup.
  • Successful surgical management with CABG and aneurysm resection was performed without complications.
  • Favorable 3-month postoperative recovery with complete symptom resolution.

Conclusions:

  • Multi-modality imaging is crucial for diagnosing complex coronary artery aneurysms.
  • Surgical intervention, including CABG and resection, is a viable treatment for symptomatic GCAA in young patients.
  • Idiopathic GCAA, though rare, requires thorough investigation and tailored management.

Keywords:
Giant coronary artery aneurysmRuptured coronary aneurysmSurgical resectionYoung adult

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