Histopathology of Giant Coronary Artery Aneurysm Associated with Coronary Artery Fistula

Matsumoto, Yuji; Kawano, Hiroaki; Iwasaki, Keisuke; Arakawa, Shuji; Maemura, Koji

doi:10.1536/ihj.17-103

Cited by 6 publications

(3 citation statements)

References 18 publications

(19 reference statements)

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“…(2) Exploring pertinent etiologies is necessary. According to other cases, Degenerated media and smooth muscle layer, suggested by the patient's pathology report, could be attributed to the occurrence of aneurysmal dilatation [19,20].…”

Section: Discussionmentioning

confidence: 72%

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

Guo

Dong

et al. 2021

BMC Cardiovasc Disord

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Background Coronary artery-to-pulmonary artery fistula is a rare disorder characterized by abnormal vascular communication between the coronary artery and pulmonary artery. While most patients remain asymptomatic, some might exhibit symptoms of myocardial ischemia, congestive heart failure, or even sudden cardiac death if coronary aneurysm, thrombosis, infective carditis, or other congenital cardiac defects coexist. Case presentation We present a 66-year-old male complaining of angina pectoris with a history of hypertension and active smoking. He was diagnosed with a coronary aneurysm based on coronary computed tomography angiography. We subsequently identified a coronary artery-to-pulmonary artery fistula with giant aneurysmal dilation on coronary angiography. Ultimately we conducted surgery ligation and aneurysmorrhaphy. During surgery, we discovered newly formed thrombus within the aneurysmal cavity. Histological analysis of the aneurysmal wall supported the diagnosis of the congenital disorder. Our patient was successfully discharged and remained asymptomatic at two months of follow-up. Conclusion We presented a rare and complex combination of congenital coronary artery-to pulmonary artery fistula, giant coronary aneurysmal dilatation, and thrombosis through multi-modality evaluations.

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Section: Discussionmentioning

confidence: 72%

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

Guo

Dong

et al. 2021

BMC Cardiovasc Disord

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“…Giant CAAs have many fatal complications, including thrombosis, rupture, myocardial ischemia, and LV dysfunction [Sugiyama 2017;Ahmed 1982]. Therefore, surgical management should occur as soon as possible after diagnosis [Matsumoto 2018].…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery–Left Ventricular Fistula with Giant Right Coronary Aneurysm: A Case Report and Literature Review

Diao

Shi

Liu

et al. 2021

HSF

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Right coronary artery–left ventricular (RCA–LV) fistula with associated giant right coronary artery aneurysm (CAA) is an extremely rare cardiac condition. This case study presents a patient with a large left ventricle (LV) and a giant right CAA with a maximal inner diameter of approximately 56.6 mm and an inner diameter of approximately 22 mm at its communication with the left ventricle. The patient underwent surgical management, involving suturing of the proximal end of the CAA and coronary artery bypass grafting (CABG). RCA–LV fistula with a giant right CAA may involve serious complications, such as thrombosis, rupture, and heart failure. Therefore, it is necessary to establish effective management strategies for this condition. Although this case is not unique, it serves as an illustrative example of the implementation of a classic surgical treatment method.

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“…Coronary artery fistula is a rare congenital abnormality characterized by direct communication between the coronary artery and a cardiac chamber or another blood vessel. 1 It can cause ventricular enlargement or congestive heart failure if the left-to-right shunt is large and may induce myocardial ischemia or arrhythmia by steal phenomenon if the shunt is small or medium in size; therefore, these cases should be treated. 2,3 Coronary aneurysms are also rare, typically acquired, and are associated with inflammatory diseases, such as atherosclerosis, Kawasaki disease, and infectious septic embolization.…”

Section: Introductionmentioning

confidence: 99%

Growing Coronary Aneurysm Secondary to Coronary Fistula Despite Decreased Pulmonary Blood Flow/Systemic Blood Flow Ratio in a Child: A Case Report

et al. 2022

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Coronary aneurysm secondary to coronary fistula is a rare condition, with no existing report on its pathological examination. We report the case of a patient diagnosed with a right coronary artery fistula with coronary aneurysm during the fetal period. During follow-up after delivery, the aneurysm became larger, even though the shunt size decreased. We were afraid the aneurysm would rupture and therefore, planned elective catheter embolization. At the age of 4 years, the patient underwent surgery, which involved closing the fistula and making the lumen of the aneurysm smaller. However, the surgery was not catheter embolization as planned because segment 3 branched off from the largest aneurysm where we planned to embolize. Pathologically, the structure of the coronary artery differed from that of a healthy one, with thickened intima and media, fewer scattered smooth muscle cells, widely distributed elastic fibers, and mucoid degeneration in the media. The structure of the coronary artery suggested that the vessel wall was weak and that the aneurysm would rupture if not treated. Postoperative coronary angiography showed that segment 2 was obstructed, while the collaterals from the left coronary artery perfused the area. We could have treated the fistula with a catheter as scheduled.

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Histopathology of Giant Coronary Artery Aneurysm Associated with Coronary Artery Fistula

Cited by 6 publications

References 18 publications

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

Congenital coronary artery-to-pulmonary fistula with giant aneurysmal dilatation and thrombus formation: a case report and review of literature

Coronary Artery–Left Ventricular Fistula with Giant Right Coronary Aneurysm: A Case Report and Literature Review

Growing Coronary Aneurysm Secondary to Coronary Fistula Despite Decreased Pulmonary Blood Flow/Systemic Blood Flow Ratio in a Child: A Case Report

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