Closure of giant coronary artery aneurysm with graft stent: a case report.

BACKGROUND

The presence of coronary aneurysm or ectasia has been associated with poor long-term outcomes, regardless of the presence of concomitant atherosclerotic coronary artery disease. The widespread use of new coronary imaging methods and the increase in coronary angiography applications in coronary artery disease have increased the frequency of rare coronary artery aneurysms (CAA).

CASE PRESENTATION

A 59-year-old male patient applied to the cardiology outpatient clinic with angina that had been present for three to four months. The patient's electrocardiography was in normal with sinus rhythm and no signs of ischemia were observed. Transthoracic echocardiography revealed a52 × 47 mm mass, which was thought to be an aneurysm or cyst, causing compression on the right atrium. Cardiac MRI and computed tomography coronary angiography was performed and an aneurysm with dimensions of 62 × 57 mm, thought to originate from the right coronary artery (RCA), was observed. Coronary angiography of the patient showed a giant coronary aneurysm of the proximal segment of RCA. The patient was evaluated by the cardiac team.For treatment, a 3.5 × 48 mm Abbott Xience Pro DES was first implanted from the proximal normal coronary artery segment to the distal normal segment beyond the aneurysm, creating a stable platform for graft stent placement. Two consecutive 4.0 × 20 mm Papyrus-Biotronik graft stents were then implanted into this DES without leaving any gaps. Post-procedurally, no contrast passage into the aneurysm was observed.

CONCLUSION

Because of the absence of available guidelines, the optimal treatment method for coronary artery aneurysms remains uncertain.