[A case of impending rupture of coronary aneurysm after rapid growth within a month]

A case of successful surgery for a rapidly growing aneurysm is described. The patient, a 47-year-old woman, had suffered from recurrent aphtous and genital ulcers for 17 years and hyperthyroidism for two years. One month after myocardial infarction, follow-up coronary angiography showed total obstruction at the distal part of the aneurysm in the left anterior descending artery with rapid dilation to 37 mm. Echocardiography revealed gradually increasing pericardial effusion. Urgent surgery was performed on January 11, 1995. Because Behçet's disease was suspected and since the vascular wall was suspected to have become fragile, surgery was performed using the aortic-no-touch technique. Under ventricular fibrillation, the proximal and distal part of the left anterior descending artery of the coronary aneurysm was ligated and bypass grafting was achieved at the distal part of the left anterior descending artery with the left internal thoracic artery. Low dose steroid treatment was started from nine days after surgery. The post operative course was satisfactory and coronary angiography during the first month showed no abnormal signs.