Department of Cardiothoracic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, 200 Lothrop Street, Ste C800, Pittsburgh, PA, 15213, USA.
Division of Thoracic Surgery, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA, USA.
Gen Thorac Cardiovasc Surg. 2021 Mar;69(3):534-537. doi: 10.1007/s11748-020-01473-5. Epub 2020 Sep 8.
Coronary artery aneurysms are exceedingly rare and tend to be found incidentally on angiography. We present the case of a 6 cm giant coronary artery aneurysm discovered in a 25 year old man. Subsequent workup included cardiac-gated MRI, CT angiography, and left heart catheterization. Imaging revealed a 6.7 × 6.2 × 6.0 cm aneurysm involving the mid LAD subsequent to the takeoff of a large septal perforator. The patient was taken electively for operative repair during which the aneurysm was opened, unroofed, and ligated at the ostium while taking care to ensuring normal flow in the septal perforator that supplied multiple small collaterals. In this unique case, a coronary artery aneurysm of considerable size was encountered in the LAD of a healthy young adult in which the size of the aneurysm precluded distal revascularization via bypass grafting. Multiple imaging modalities were used to characterize this finding and aid in surgical planning.
冠状动脉瘤非常罕见，往往在血管造影时偶然发现。我们报告了一例 25 岁男性发现的 6cm 巨大冠状动脉瘤。进一步的检查包括心脏门控 MRI、CT 血管造影和左心导管检查。影像学显示一个 6.7×6.2×6.0cm 的动脉瘤，位于大间隔穿孔支发出后的 LAD 中段。该患者择期行手术修复，术中打开动脉瘤，在开口处切除并结扎，同时注意确保为供应多个小侧支的间隔穿孔支提供正常血流。在这个独特的病例中，在一个健康的年轻成年人的 LAD 中发现了一个相当大的冠状动脉瘤，动脉瘤的大小排除了通过旁路移植进行远端血运重建的可能。多种成像方式用于对这一发现进行特征描述并辅助手术计划。
