Skip to content
The reference academic journal by and for the Asia-Pacific interventional cardiology community
AsiaIntervention

AsiaIntervention

  • Current Issue
  • Archives
  • How to submit
    • Authors guidelines
    • Submit your paper
  • Services
    • Advertising
    • Article reprints
    • Publication calendar
    • Rights & Permissions
  • About the journal
    • Overview
    • Editorial Board
    • Masthead
  • Contact us
Volume 6 – Number 1 – July 2020

Very rare giant coronary aneurysm

AsiaIntervention 2020;6:50-51 | 10.4244/AIJ-D-18-00029

Rajeshwari Nayak1, DNB; Yeramma Vijayachandra Reddy1, DM, MD, MRCP; Girinath Maligail Ramakrishnan1, MS, FRCSC; Rochita Ramanan1; Sathyamurthy Immineni1, MD, DM; Jenifer Johnson1, BS

1. Apollo Hospitals, Chennai, India

Coronary artery aneurysms (CAA) are rare and giant CAA are even rarer. We describe an asymptomatic patient with a giant CAA of the right coronary artery (RCA). A 65-year-old underwent echography (Panel A & Panel B), as part of his medical evaluation for a life insurance policy, which revealed a lesion in the right atrium (RA).

A coronary angiogram revealed a giant aneurysm of the mid-segment of the RCA (Panel F & Panel G). CT coronary angiogram (CTA) revealed a large fusiform aneurysm, measuring 32.1 mm×46 mm (Panel C, Panel D & Panel E).

Management options of percutaneous coronary intervention (PCI) with covered stent and surgical repair were discussed. PCI was not a viable option as the artery proximal and distal to the aneurysm appeared highly ectatic.

He underwent surgical repair (Panels H&I). A coronary artery bypass graft was performed using saphenous vein grafts to the posterior descending artery and the acute marginal branches. The RCA proximal and distal to the aneurysm was ligated. A third ligature was placed around the origin of the acute marginal branch, achieving complete isolation of the aneurysm.

At 1-year follow-up, echography showed a persisting RCA aneurysm. CTA showed an aneurysm measuring 40 mm×32 mm, partially thrombosed, with evidence of persistent filling from the native RCA. The large size of the aneurysm and the persistent filling by the RCA placed the patient at considerable risk of aneurysmal rupture and sudden cardiac death.

The patient underwent repeat surgery and the RCA was ligated totally at its origin. At 1-year follow-up after the second surgery, there was no echocardiographic evidence of a persisting lesion. CTA revealed a fully thrombosed RCA aneurysm.

Conflict of interest statement

The authors have no conflicts of interest to declare.

Share

Volume 6 - Number 1

View full issue

Download this article
Authors
  • Girinath Maligail Ramakrishnan
  • Jenifer Johnson
  • Rajeshwari Nayak
  • Rochita Ramanan
  • Sathyamurthy Immineni
  • Yeramma Vijayachandra Reddy
AsiaIntervention
  • Readers
    • Archives
    • Subscribe to the newsletter
    • Contact us
  • About the journal
    • Overview
    • Editorial Board
    • Masthead
  • Services
    • Advertising in AsiaIntervention
    • Article reprints
    • Publication calendar
    • Rights & Permissions
  • Authors
    • Authors guidelines
    • Submit your paper
  • Legal
    • Disclaimer
    • Cookies Policy
    • Privacy Policy
    • Legal Notice
  • Follow us
    • Facebook
    • Twitter
    • LinkedIn
Online ISSN 2491-0929 - Print ISSN 2426-3958
© 2015-2023 Europa Group - All rights reserved