Stazka Janusz, Olszewski Krzysztof, Krawczyk Elzbieta
Department of Cardiac Surgery, Skubiszewski Medical University of Lublin.
Ann Univ Mariae Curie Sklodowska Med. 2004;59(1):307-9.
Coronary artery aneurysms are very rare abnormalities in patients undergoing coronary angiography. Clinical manifestation is usually that of coronary artery disease, and acute myocardial infarction. We present the case of a patient admitted to the Department of Cardiac Surgery due to coronary artery disease and the presence of thrombus in right atrium of the heart diagnosed by transthoracic echocardiography. Coronary angiography showed occlusion of the right coronary artery (RCA) in its middle portion, 20% stenosis of the stem of the left coronary artery in distal portion and occlusion of circumflex coronary artery (CX) and the second obtuse marginal branch (OM 2). During surgery no tumor was found within the right atrium, but right coronary artery giant aneurysm was revealed. The totally thrombosed aneurysm was removed with additional performance of two venous grafts to RCA and OM 2. The postoperative course was uneventful.
冠状动脉瘤在接受冠状动脉造影的患者中是非常罕见的异常情况。其临床表现通常为冠状动脉疾病及急性心肌梗死。我们报告一例因冠状动脉疾病及经胸超声心动图诊断发现心脏右心房存在血栓而入住心脏外科的患者。冠状动脉造影显示右冠状动脉（RCA）中段闭塞，左冠状动脉主干远端20%狭窄，回旋支冠状动脉（CX）及第二钝缘支（OM 2）闭塞。手术中未在右心房内发现肿瘤，但发现了右冠状动脉巨大动脉瘤。切除完全血栓形成的动脉瘤，并额外进行了两根静脉移植至RCA和OM 2。术后过程顺利。
