Alshehri Abdullah M
Department of Internal Medicine, Imam Abdulrahman Bin Faisal University, Al-Khobar, Saudi Arabia.
Saudi J Med Med Sci. 2019 Sep-Dec;7(3):187-189. doi: 10.4103/sjmms.sjmms_47_18. Epub 2019 Aug 28.
Left main coronary artery aneurysms are very rare and are incidentally encountered in about 0.1% of patients undergoing angiography. Atherosclerosis represents the main cause of this aneurysm in adult patients. Here, the author presents a case of a 58-year-old female with a history of hypertension and diabetes who had a Canadian Cardiovascular Society Grade II-III angina for the past 6 months. Selective coronary angiography revealed a large aneurysm involving the left main coronary artery (measuring 2 cm × 3 cm) with extensive coronary calcifications, ectatic proximal left circumflex followed by 80% stenotic lesion with normal left anterior descending and right coronary artery. The patient was managed with coronary artery bypass grafting along with ligation of the aneurysm. At the 3-month follow-up, the patient was asymptomatic. Therefore, distal coronary artery bypass surgery represents one of the therapeutic options and was safe and effective in our case.
左冠状动脉主干动脉瘤非常罕见,在接受血管造影的患者中约0.1%偶然发现。动脉粥样硬化是成年患者这种动脉瘤的主要病因。在此,作者报告一例58岁女性患者,有高血压和糖尿病史,过去6个月有加拿大心血管学会II-III级心绞痛。选择性冠状动脉造影显示一个累及左冠状动脉主干的大动脉瘤(大小为2 cm×3 cm),伴有广泛冠状动脉钙化,左旋支近端扩张,随后左前降支和右冠状动脉正常,但有80%的狭窄病变。该患者接受了冠状动脉旁路移植术并结扎动脉瘤。在3个月的随访中,患者无症状。因此,远端冠状动脉旁路手术是一种治疗选择,在我们的病例中是安全有效的。