Department of Cardiac Surgery, Ospedale Santa Maria della Misericordia, Azienda Ospedaliera di Perugia, Perugia, Italy.
J Card Surg. 2021 Aug;36(8):2944-2945. doi: 10.1111/jocs.15591. Epub 2021 May 3.
Coronary artery aneurysms are an uncommon disease whose incidence ranges from 0.3% to 5.3%. The right coronary artery is affected in 40%-70% of cases. Percutaneous coronary angioplasty is among causative factors, in particular with stent implantation.
We present a case of large postangioplasty aneurysm of the right coronary artery requiring surgical correction.
MATERIALS & METHODS: A 70-year-old man with history of multiple coronary angioplasty procedures was admitted with diagnosis of aneurysm of the right coronary artery at the site of past DES insertion.
Under cardiopulmonary bypass, the large aneurysm was incised and oversewn with final grafting of the posterior descending artery with in situ right internal mammary artery. The postoperative course was uneventful.
The treatment options for coronary artery aneurysms range from medical, percutaneous and surgical approaches.
In this case the surgical approach was indicated due to the large aneurysm and the high risk of rupture.
冠状动脉瘤是一种罕见的疾病，发病率为 0.3%至 5.3%。40%-70%的病例累及右冠状动脉。经皮冠状动脉血管成形术是其致病因素之一，特别是支架植入术。
我们报告一例右冠状动脉经皮血管成形术后大型动脉瘤，需要手术矫正。
一名 70 岁男性，有多次冠状动脉血管成形术病史，因既往 DES 置入部位的右冠状动脉瘤而入院。
在体外循环下，切开大动脉瘤，用原位右内乳动脉对后降支进行吻合，最后进行搭桥。术后过程顺利。
冠状动脉瘤的治疗选择包括药物、经皮和手术方法。
在这种情况下，由于动脉瘤较大且破裂风险高，因此采用了手术方法。
