Giant Right Coronary Artery Aneurysms

Chalkley, Robin A.; Roberts, William C.; Patlolla, Srikant; Schussler, Jeffrey M.; Snyder, Richard; Smith, Robert L.; Roberts, Charles S.; Meyer, Dan M.

doi:10.1016/j.amjcard.2020.02.008

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…Núñez-Gil et al reported 1561 adults with coronary aneurysms from a European registry; 82 (5%) had aneurysms ≥4 cm in size 17. At least seven case reports have been reported describing coronary aneurysms ranging in size from 6 cm to 10 cm 18…”

Section: Discussionmentioning

confidence: 99%

“…Although its usefulness in patients with small (<2 cm) coronary aneurysms is not clear, aneurysmal resection for a gigantic CAA (>2 cm) is recommended to prevent severe narrowing or obstruction of the lumen of the coronary artery from which they arise to prevent their bulging into a cardiac chamber, potentially causing valve regurgitation, obstruction, arrhythmia and preventing rupture 18. A variety of operative procedures have been performed: aneurysmal clipping and excision with coronary bypass grafting (as done in our case); resection with end-to-end anastomoses or interposition vein grafts and aneurysmal thrombectomy without sac resection is another acceptable alternative.…”

Section: Discussionmentioning

confidence: 99%

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Giant right coronary artery aneurysm in a dominant right system

Ali,

Khan,

Farooq

et al. 2023

BMJ Case Rep

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Giant coronary artery aneurysms (GCAAs) are unusual and extremely rare. Due to their rarity, there is a lack of data on managing GCAAs. A man in his 70s who presented with worsening shortness of breath and bilateral lower extremity oedema was found to have non-ST elevation myocardial infarction. Coronary angiography showed a tortuous Shepherd’s crook right coronary artery with ectasia and a gigantic 4.5×4 cm saccular aneurysm in the mid-right coronary artery with limited flow to the distal vasculature. He subsequently underwent aneurysmal clipping and excision with coronary artery bypass grafting. GCAAs are usually silent and diagnosed incidentally but can also present with variable cardiac symptoms. Treatment options include medical management, percutaneous coronary angioplasty and surgery. As per limited available literature, surgical resection has shown favourable outcomes, especially in symptomatic GCAAs. The patient reported significant symptomatic improvement on the follow-up office visit.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Giant right coronary artery aneurysm in a dominant right system

Ali,

Khan,

Farooq

et al. 2023

BMJ Case Rep

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“…In this case, we performed elective surgery for a 4.5-cm-diameter coronary aneurysm considering the risk of aneurysm rupture and the patient’s young age in the absence of related symptoms. Although there are no size-specific surgical indications for coronary aneurysms, resection of coronary aneurysms larger than 4 cm is reasonable to prevent complications such as obstruction, arrhythmia, and rupture [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

True Aneurysm of the Common Coronary Button in a Marfan Patient with an Anomalous Right Coronary Artery after a Bentall Procedure: A Case Report

Kim

et al. 2022

J Chest Surg

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True aneurysms of the coronary artery after aortic root replacement in Marfan syndrome patients are very rare. An anomalous origin of the right coronary artery (RCA) from the left sinus of Valsalva adds complexity during aortic root surgery. We present a case of a 37-year-old male patient with Marfan syndrome who had an RCA anomaly and a 4.5-cm true aneurysm of the common coronary button 14 years after a previous Bentall procedure. A redo Bentall operation and hemi-arch replacement were successfully performed. The anomalous origin of the RCA from the left sinus of Valsalva was safely divided and anastomosed as separate coronary buttons to the prosthetic composite valve graft. To prevent coronary button aneurysms after aortic root surgery in Marfan patients, the coronary buttons and the corresponding side holes on the prosthetic graft must be reduced to the maximum possible extent.

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