Coil embolization for ruptured coronary pseudoaneurysm causing haemopericardium: a case report

Background Coronary artery pseudoaneurysm is a rare disease that can rupture and cause haemopericardium. It can occur principally as a complication after coronary artery instrumentation, but it can also result from trauma. Case summary A 15-year-old male patient with a history of spontaneous pneumothoraces treated twice with video-assisted thoracoscopic thoracic surgery presented with pericarditis and increasing haemopericardium. During the hospitalization, he had developed cardiogenic shock and he underwent emergent pericardiocentesis. Coronary angiography revealed a small right coronary artery pseudoaneurysm. We successfully coil embolized the pseudoaneurysm. Discussion This is a rare case of a ruptured coronary artery pseudoaneurysm associated with prior tube thoracostomy. The treatments for a coronary pseudoaneurysm should be tailored based on the pathologic and anatomical characteristics.

Surgical Treatment of Coronary Pseudoaneurysm: A Case Report and Literature Review

A coronary pseudoaneurysm is a rare complication of chest trauma. In this report, we describe the case of a 65-year-old man with a mediastinal lesion. On admission, he complained of chest tightness and dry cough, and a pseudoaneurysm was confirmed in the left anterior descending branch of the coronary artery on chest computerized tomography, angiography, and coronary angiography. The patient had experienced chest trauma 5 years previously. With the help of extracorporeal bypass surgery, the pseudoaneurysm was resected under direct observation. The patient recovered well after surgery. Traumatic coronary artery pseudoaneurysms usually are asymptomatic and often misdiagnosed. Preoperative coronary angiography is a crucial diagnostic used for deciding appropriate surgical management.

COMPLICATED COURSE OF LATE PATIENT’S SURVIVAL AFTER THE CLASSIC BENTALL PROCEDURE WITH THE CABROL SHUNT

In the setting of bleeding into the perigraft space, the classic Bentall operation can be modified by the usage of the Cabrol shunt. This shunt is applied in order to drain the blood into the right atrium and it is expected to close gradually. Anastomotic suture line disruption along with concomitant blood flow into the perigraft space may rarely open the shunt and cause the right heart failure. Due to the anastomotic complications, the classic Bentall operation no longer is widely used in clinical practice, but patients who underwent such procedure some decades ago may be coping with various symptoms nowadays. In this article, the cases of anastomotic disruption as well as pseudoaneurysm formation and the opening of the Cabrol shunt 21 years after such kind of operation are presented. The patient underwent surgical repair and was confronted with the reoccurrence of the coronary pseudoaneurysm three years later.