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Coronary artery aneurysm repaired with saphenous vein patch plasty
Y Moriyama1, K Hisatomi, S Shimokawa
1Second Department of Surgery, Kagoshima University, Faculty of Medicine, Kagoshima City, Japan.
The Annals of Thoracic Surgery
|March 4, 1998
Summary
Atherosclerotic coronary artery aneurysms can expand and lead to complications. This case demonstrates successful surgical repair using a saphenous vein patch and bypass grafting, ensuring aneurysm resolution and graft patency.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Vascular Medicine
Background:
- Atherosclerotic coronary artery aneurysms (ACAs) are uncommon vascular lesions.
- While not always requiring intervention, expanding ACAs pose risks of rupture or embolism.
- Optimal management strategies for ACAs remain debated.
Observation:
- A case involving a patient with an ACA in the left anterior descending coronary artery (LAD) above the first septal perforator is presented.
- The aneurysm showed progressive expansion, indicating a potential risk for complications.
Findings:
- Successful surgical repair was achieved using a saphenous vein patch for the aneurysm.
- Simultaneously, a right gastroepiploic artery (RGEA) graft was constructed to the occluded right coronary artery (RCA).
- Follow-up angiography at 6 months showed complete aneurysm resolution, no luminal stenosis, a preserved septal branch, and widely patent RGEA graft.
Implications:
- This case highlights the feasibility and effectiveness of surgical repair for complex coronary artery aneurysms.
- Combined aneurysm repair with coronary artery bypass grafting can be a successful strategy.
- Preservation of critical branches and graft patency are crucial for long-term outcomes.