Right Coronary Artery Aneurysm Communication with the Right Atrium Following Non–ST-Elevation Myocardial Infarction Treated With Coil Embolization

Abstract Background: Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. Case Presentation: We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 x 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. Conclusion: The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications. Keywords: coronary artery aneurysm, aortic aneurysm, atherosclerosis, non-ST segment 32 elevation myocardial infarction, case report

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Novel use of the AGILISTM-NxT steerable introducer-sheath in a patient with ST-elevation myocardial infarction and anomalous origin of the right coronary artery

Acta Cardiologica ◽

10.1080/00015385.2018.1480470 ◽

2018 ◽

Vol 74 (3) ◽

pp. 271-272

Author(s):

Sebastian Völz ◽

Dan Ioanes ◽

Erika Fagman ◽

Petur Petursson ◽

Jacob Odenstedt

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Right Coronary Artery ◽

St Elevation Myocardial Infarction ◽

Anomalous Origin ◽

Introducer Sheath ◽

St Elevation ◽

The Right

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Rupture of right coronary artery aneurysm into the right atrium.

Heart ◽

10.1136/hrt.40.8.938 ◽

1978 ◽

Vol 40 (8) ◽

pp. 938-939 ◽

Cited By ~ 8

Author(s):

R W Chapman ◽

J Watkins

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Right Atrium ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

The Right

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Proximal Left Main Coronary Artery Aneurysm Presenting as ST-Elevation Myocardial Infarction Treated by Stenting

Case Reports in Cardiology ◽

10.1155/2020/8833917 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Vijay Chander Vinod ◽

Zuhair Eltayeb Yousif ◽

Najat Omer Salim ◽

Talib Majwal

Keyword(s):

Myocardial Infarction ◽

Coronary Artery ◽

Coronary Angiography ◽

Coronary Artery Aneurysm ◽

Left Main Coronary Artery ◽

Artery Aneurysm ◽

St Elevation Myocardial Infarction ◽

Maximum Diameter ◽

Left Main ◽

St Elevation

Coronary artery aneurysm (CAA) is a rare cardiac anomaly with a reported incidence of 0.3-4.9% of patients who undergo coronary angiography. The term is used when the coronary artery diameter exceeds more than 50% or 1.5 times the reference diameter. It can be congenital or acquired. The commonest acquired cause in an adult is atherosclerosis and in a child is Kawasaki’s disease. The commonest culprit vessel is the Right Coronary Artery (RCA), followed by Left Circumflex (LCx) and Left Anterior Descending (LAD). Left main coronary aneurysms are extremely rare in clinical practice. Coronary angiography is the gold standard procedure, both for diagnosis and treatment. We report a 49-year-old male who presented with anterior wall ST-Elevation Myocardial Infarction (STEMI). The initial angiography showed LAD stent thrombosis, but when the second angiography was done, there was spontaneous recanalization of the LAD. Coronary angiography was performed at our hospital, which revealed a long left main coronary artery aneurysm measuring 9.8 mm—maximum diameter. This was treated with a size 5 × 24 mm Begraft coronary stent.

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Giant right coronary artery aneurysm complicated by a fistula to the right atrium, mimicking a ruptured sinus of Valsalva aneurysm

BMJ Case Reports ◽

10.1136/bcr-2018-226197 ◽

2018 ◽

pp. bcr-2018-226197

Author(s):

Masaki Kodaira ◽

Takahito Itoh ◽

Kiyoshi Koizumi ◽

Yohei Numasawa

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Right Atrium ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Coronary Aneurysm ◽

Sinus Of Valsalva ◽

Sinus Of Valsalva Aneurysm ◽

Multiple Imaging ◽

The Right

Patients with a coronary aneurysm alone do not generally exhibit continuous murmurs; however, murmurs may be detected in the presence of a fistula. A 57-year-old woman with chest pain was referred to us with a suspected diagnosis of a ruptured sinus of Valsalva aneurysm owing to the presence of a continuous murmur that was detected on physical examination. However, CT revealed a giant right coronary artery aneurysm draining into the right atrium. Consequently, surgery was performed. This case highlights the importance of implementing multiple imaging modalities for adequate differential diagnoses of patients presenting with continuous murmurs.

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