Isolated Huge Aneurysm of the Left Main Coronary Artery in a 22-Year-Old Patient With Type 1 Neurofibromatosis

Pontailler, Margaux; Vilarem, D; Paul, Jean-François; Deleuze, Philippe

doi:10.1016/j.athoracsur.2014.05.062

Cited by 8 publications

(5 citation statements)

References 8 publications

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“…Tins et al (125) characterized a 6-cm CAA in an asymptomatic patient with neurofibromatosis type 1 by using CT and MR imaging. Various case reports document a single CAA in living patients with neurofibromatosis type 1 (126)(127)(128), multiple CAAs (129)(130)(131), and coronary ectasia (132). Unfortunately, sudden death is a more common manifestation of neurofibromatosis type 1 with coronary artery involvement, usually owing to coronary thrombus formation and myocardial infarction (124,127,129,(133)(134)(135)(136).…”

Section: Neurofibromatosis Typementioning

confidence: 99%

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Jeudy¹,

White²,

Kligerman³

et al. 2018

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Advances in medical diagnosis reveal that coronary artery aneurysms (CAAs) may develop in several clinical scenarios and manifest variable symptoms, imaging appearances, and outcomes. Aneurysms are pathologically classified into three groups: atherosclerotic, inflammatory, and noninflammatory. The last category is associated with congenital, inherited, and connective tissue disorders. Overlap exists among the groups, because secondary atherosclerotic change may be present in an aneurysm of any cause. Atherosclerosis is the most common cause of CAAs in adults, and inflammation is considered the underlying mechanism. In children, Kawasaki disease is the most likely cause of CAAs. In both conditions, the aneurysms are usually multiple and affect more than one coronary artery. Mycotic (infectious), iatrogenic, and cocaine-induced CAAs are also well documented. Most CAAs are discovered incidentally, but potential cardiovascular complications include thrombosis, occlusion, fistula formation, rupture, myocardial infarction, and cardiac tamponade. Imaging modalities to evaluate a suspected CAA include transthoracic echocardiography, angiographic cardiac catheterization, electrocardiographically gated computed tomographic angiography, cardiac magnetic resonance (MR) imaging, and MR angiography. Management is usually individualized, and options include surveillance, anticoagulant therapy, percutaneous stent or coil placement, surgical resection, and coronary artery bypass grafting.

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Section: Neurofibromatosis Typementioning

confidence: 99%

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Jeudy¹,

White²,

Kligerman³

et al. 2018

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“…Here we took a different surgical approach. The proximal and distal fistula was closed by running suture which did not affect the coronary flow and avoided CABG surgery compared with the approach reported by Margux and colleagues [6]. Trans-catheter occlusion with embolization reported by Wang et al [7] is another therapeutic choice for this disease, but the AR in our patient made the trans-catheter occlusion procedure unsuitable.…”

Section: Discussionmentioning

confidence: 69%

Giant aneurysm of the left main coronary artery with fistulous communication to the right atrium

Zhu

Wang

et al. 2015

J Cardiothorac Surg

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The giant coronary artery aneurysm combined with coronary artery fistula is extremely uncommon. In our case, there was a giant aneurysm of the left main coronary artery with fistulous communication to the right atrium, combined with moderate aortic valve regurgitation, which was initially found by transthoracic echocardiogram and subsequently confirmed by the 256-slice multidetector computer tomography (MDCT) coronary angiography. After consultation, the patient received surgical treatment, including the closure of the drainage and origin sites of the aneurysm and the aortic valve replacement. The patient recovered uneventfully.

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“…Published reports describe the following surgical options for managing LMT aneurysm: CABG alone; CABG and ligation of both ends of the aneurysm [8]; CABG, ligation of the distal side of the aneurysm, and left coronary ostium closure [11,12]; CABG and repair [13]; and CABG and polytetrafluoroethylene (PTFE)-covered stent implantation [14,15]. There have been no reports of death associated with any of these surgical procedures, which are, therefore, considered safe and feasible.…”

Section: Discussionmentioning

confidence: 99%

Surgical exclusion of an idiopathic saccular aneurysm in the left main trunk of the coronary artery

et al. 2021

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Purpose A coronary artery aneurysm (CAA) can result in critical cardiac events such as thromboembolic complications or rupture. A saccular CAA located in the left main trunk (LMT) is the most critical form of this pathology and its surgical repair is challenging. We conducted this single-center study to review the surgical outcomes of patients with a saccular CAA in the LMT. Methods Between May, 2012 and June, 2020, five patients with a saccular CAA in the LMT underwent surgery at our center. The median age at operation was 66.5 (59.7–69) years and the median diameter of the CAA was 13.0 mm (IQR 11–14 mm). Results The CAA was fully excluded by patch closure of the LMT orifice and direct closure of the distal LMT, supplemented by coronary artery bypass grafting with the exclusive use of arterial conduits. There was no in-hospital mortality, although one patient suffered graft spasm-related myocardial infarction with complete recovery. Post-operative angiography showed a fully excluded LMT in all patients. There was no mortality or adverse cardiac events during follow-up. Conclusions Our surgical policy for CAA in the LMT is feasible and safe; however, coronary blood flow is dependent on reliable bypasses.

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Isolated Huge Aneurysm of the Left Main Coronary Artery in a 22-Year-Old Patient With Type 1 Neurofibromatosis

Cited by 8 publications

References 8 publications

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Spectrum of Coronary Artery Aneurysms:From the Radiologic Pathology Archives

Giant aneurysm of the left main coronary artery with fistulous communication to the right atrium

Surgical exclusion of an idiopathic saccular aneurysm in the left main trunk of the coronary artery

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