Giant right coronary artery aneurysm. Case Report

Introduction: Coronary aneurysms are rare and are linked to drug abuse; symptomatology depends on the coronary anatomy. This is a case of acute coronary syndrome associated with a giant right coronary aneurysm.Case description: A 40-year-old male, with history of heroin and crack use since age 20, attended consultation due to dyspnea, stable angina and diaphoresis. An electrocardiogram showed ST segment overlay on the underside and troponin problems. A coronary catheterization was performed, which revealed apparent inconclusive aortato-right atrium fistula. Based on the findings, angiotomography and magnetic resonance imaging were performed, finding a giant right coronary aneurysm. The aneurysm was resected using extracorporeal circuit, femoral cannulation, moderate hypothermia, aortic cross-clamping and cardioplegia, and the right coronary artery was revascularized with the left internal saphenous vein. The patient had a satisfactory postoperative period and was discharged after 7 days.Conclusion: There is an important association between drug use and the development of coronary aneurysms. Aneurysm size makes diagnosis difficult, so complementary studies are necessary to establish a differential diagnosis. An appropriate surgical approach allows for a complete resection of the aneurysm and optimal coronary revascularization.

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Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion

Case Reports in Surgery ◽

10.1155/2016/3795640 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

James Barr ◽

Metesh Nalin Acharya ◽

Antonios Kourliouros ◽

Shahzad Gull Raja

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Coronary Artery Aneurysm ◽

Surgical Repair ◽

Saphenous Vein Graft ◽

Artery Aneurysm ◽

Coronary Artery Aneurysms ◽

Coronary Aneurysms ◽

Right Ventricular Strain ◽

The Right

Giant coronary artery aneurysms are rare clinical entities. We report the case of a 49-year-old man who presented with dyspnoea and exertional chest pain. Investigations confirmed an aneurysmal right coronary artery measuring 4 cm with a fistulous communication to the right atrium. Following right atriotomy, the fistula was oversewn and the aneurysmal right coronary artery ligated at its origin and at several points along its course. A saphenous vein graft was anastomosed to the posterior descending artery. Persistent ventricular fibrillation occurred upon chest closure, attributed to ischaemia following ligation of the aneurysmal coronary artery. Emergent resternotomy and internal defibrillation were successfully performed. The sternum was stented open to reduce right ventricular strain and closed the following day. The patient made an unremarkable recovery. We here address the technical challenges associated with surgical repair of right coronary aneurysms and the physiology and management of potential complications.

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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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Surgical treatment of coronary atherosclerotic heart disease with right coronary artery aneurysm: a case report

Perfusion ◽

10.1177/0267659120929489 ◽

2020 ◽

pp. 026765912092948

Author(s):

Feng Wang ◽

Guiqing Liu ◽

Xin Mao

Keyword(s):

Case Report ◽

Coronary Artery ◽

Surgical Treatment ◽

Right Coronary Artery ◽

Artery Bypass ◽

Coronary Aneurysm ◽

Bypass Grafting ◽

Coronary Artery Aneurysms ◽

Coronary Aneurysms ◽

The Right

Introduction: The etiology of coronary artery aneurysms is unknown. Coronary atherosclerosis is considered to be the main etiology. This case reports a patient with a large coronary aneurysm of the right coronary artery. Case report: A 65-year-old woman was hospitalized with intermittent chest pain and underwent coronary angiography and echocardiography which showed a large coronary aneurysm of the right coronary artery. The patient recovered well after ligation of coronary artery aneurysms with additional coronary artery bypass grafting. Discussion: The etiology of coronary aneurysms is unknown, which is relatively rare and mostly secondary. Majority of coronary artery aneurysms are located in the right coronary artery. There is currently no standard treatment. Surgical treatment of coronary artery aneurysms may be considered as a safe treatment option. Conclusion: The standard surgical treatment for coronary artery aneurysms is unclear. For symptomatic large coronary aneurysms, ligation of coronary artery aneurysms with additional coronary artery bypass grafting can achieve good results.

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Treatment of Left Anterior Descending Artery Aneurysm

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2006.3113 ◽

2008 ◽

Vol 6 (4) ◽

pp. 22-24

Author(s):

Mirsad Kacila ◽

Marco L.S. Matteucci ◽

Stefano Bevilacqua ◽

Nermir Granov ◽

Mattia Glauber

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Artery Aneurysm ◽

Surgical Revascularization ◽

Coronary Artery Aneurysms ◽

Off Pump ◽

Left Anterior Descending Artery ◽

Coronary Aneurysms ◽

The Right

Coronary artery aneurysms (CAAs) are rare and their management is controversial. Their incidence varies from 1,5% to 5% of the coronary angiographies, with predilection of the right coronary artery. Unruptured coronary aneurysms are often silent and may remain undiagnosed. The etiology can be either congenital or acquired. We describe a case of a left anterior descending artery (LAD) aneurysm treated with an off-pump surgical revascularization with a LIMA to LAD without exclusion or ligature of the aneurysm.

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Acute coronary syndrome with unusual form of right coronary artery aneurysm and treated with overlapping two covered stents across coronary aneurysm: case report

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20160830 ◽

2016 ◽

pp. 1295-1297

Author(s):

Naresh Sen ◽

Keum Park

Keyword(s):

Acute Coronary Syndrome ◽

Case Report ◽

Coronary Artery ◽

Right Coronary Artery ◽

Coronary Artery Aneurysm ◽

Artery Aneurysm ◽

Coronary Aneurysm ◽

Covered Stents ◽

Coronary Syndrome ◽

Unusual Form

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Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

The Heart Surgery Forum ◽

10.1532/hsf98.2013246 ◽

2014 ◽

Vol 17 (4) ◽

pp. 196

Author(s):

Erhan Kaya ◽

Halit Yerebakan ◽

Daniel Spielman ◽

Omer Isik ◽

Cevat Yakut

Keyword(s):

Coronary Artery ◽

Aortic Dissection ◽

Right Coronary Artery ◽

Type A ◽

Sudden Onset ◽

Acute Type ◽

Type A Aortic Dissection ◽

Coronary Syndrome ◽

Bentall Procedure ◽

The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

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Giant right coronary artery aneurysm

Journal of Transcatheter Interventions ◽

10.31160/jotci202028a20200021 ◽

2020 ◽

Vol 28 ◽

pp. 1-3

Author(s):

Alexandre Bonfim ◽

Ronald Souza ◽

Sérgio Beraldo ◽

Frederico Nunes ◽

Daniel Beraldo

Keyword(s):

Coronary Artery ◽

Right Coronary Artery ◽

Coronary Artery Aneurysm ◽

Clinical Course ◽

Artery Aneurysm ◽

Giant Aneurysm ◽

Coronary Artery Aneurysms ◽

History Of ◽

Artery Disease ◽

The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

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Patient with Acute Coronary Syndrome in the Setting of an Extremely Rare form of Complex Congenital Anomalous Coronaries

Aorta ◽

10.1055/s-0041-1729852 ◽

2021 ◽

Author(s):

Mahmoud Abdelnabi ◽

Fady Gerges ◽

Yehia Saleh ◽

Eman Elsharkawy ◽

Mohamed Sanhoury ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Young Patient ◽

Right Coronary Artery ◽

Unusual Case ◽

Single Coronary Artery ◽

Sinus Of Valsalva ◽

Rare Form ◽

Coronary Syndrome ◽

The Right

AbstractA single coronary artery is an exceedingly rare anomaly. Hereby, we present an unusual case of a young patient with an acute coronary syndrome who was found to have a single coronary artery originating from a single ostium in the right sinus of Valsalva with dual left anterior descending (LAD) arteries arising from the right coronary artery with two different anatomical courses, and additionally one of those LADs running a malignant intra-arterial course.

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A right coronary artery aneurysm 16 years after surgical repair of anomalous origin of the right coronary artery from the pulmonary artery

Interactive CardioVascular and Thoracic Surgery ◽

10.1093/icvts/ivy356 ◽

2019 ◽

Vol 29 (1) ◽

pp. 157-158

Author(s):

Akira Furutachi ◽

Kojiro Furukawa ◽

Aiko Komatsu ◽

Eijiro Nogami

Keyword(s):

Coronary Artery ◽

Pulmonary Artery ◽

Right Coronary Artery ◽

Surgical Repair ◽

Artery Aneurysm ◽

Anomalous Origin ◽

Artery Graft ◽

Long Term Follow Up ◽

The Right

Abstract Anomalous origin of the right coronary artery (RCA) from the pulmonary artery is a very rare congenital heart disease, and several reports have described long-term events after surgery. We report the case of a 46-year-old woman who underwent reimplantation of the RCA for anomalous origin of the right coronary artery from the pulmonary artery 16 years ago. An RCA aneurysm gradually developed and dilated over time, and we resected the aneurysm and also grafted the right gastroepiploic artery graft to the distal RCA. Careful long-term follow-up is required to avoid overlooking such a rare but life-threatening complication after surgical repair of anomalous origin of the right coronary artery from the pulmonary artery.

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