An Extremely Large Coronary Aneurysm Associated with a Quadricuspid Aortic Valve in an Adult Patient

Abstract

A 68-year-old woman exhibited an increasingly protruding mass on the left heart border on chest X-ray. Transthoracic echocardiography revealed an echo-free mass in the anterior pericardial space. Transesophageal echocardiography revealed blood flow from the proximal left anterior descending coronary into a large coronary artery aneurysm measuring 61 mm × 51 mm in diameter and a quadricuspid aortic valve with a small cusp between the left and right coronary cusps. Coronary angiography demonstrated the presence of a coronary aneurysm connected to the proximal left coronary anterior descending artery. A giant coronary artery aneurysm and pulmonary artery fistulas extending from the left and right coronary arteries were confirmed by surgeons and successfully treated with surgery.

Quadricuspid Aortic Valve, Single Coronary Artery, Solitary Kidney and Oblique Facial Cleft. A Unique Constellation of Congenital Abnormalities: Case Report and Review of the Literature

“…While in the majority of patients with QAV, the ostia of the coronary arteries are in the normal anatomical positions relative to the aortic root, the position of the coronary artery ostia relative to the aortic sinuses of Valsalva will naturally vary from that in the trileaflet valve [8]. Reported coronary artery anomalies include anomalous position of one of the coronary ostia, single coronary ostium [27], coronary-pulmonary artery fistula [24,28] and giant coronary artery aneurysm [28]. The association of QAV and single coronary ostium is very rare and has only been reported in one case before [1].…”

An Unlucky Four-Leaf Clover Stenosis With a Single Coronary Artery

“…Coronary artery anomalies are reported in 10% of QAV cases [ 3 ]. Reported coronary artery anomalies include abnormalities in the origin, course of one of the coronary arteries, coronary-pulmonary artery fistula, and giant coronary artery aneurysm [ 6 , 7 ].…”

Dual Aneurysms of the Left Anterior Descending Coronary Artery Initially Detected by Echocardiography

“…36) Once it gets worse, they may present with congestive heart failure, sudden death, or complications such as thrombus formation, embolization, fistula formation, rupture, hemopericardium, tamponade, or compression of the surrounding structure. 37) All the serious complications mentioned above emphasized the clinical relevance of early correct diagnosis of CAAs and coexisting anomalies. Echocardiography is currently the preferred method for screening and early diagnosis of this deformity.…”