Chest X-Ray Revealed a Slowly Progressive Giant Right Coronary Artery Aneurysm in an Asymptomatic Patient

Cardiology ◽  
2018 ◽  
Vol 139 (4) ◽  
pp. 231-233
Author(s):  
Masaru Hiki ◽  
Hiroshi Iwata ◽  
Yuko Kawaguchi ◽  
Kazuhisa Takamura ◽  
Makoto Hiki ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Right Atrial ◽  
Specific Symptom ◽  
X Ray ◽  
Giant Coronary Artery Aneurysm ◽  
Atrial Enlargement ◽  
Chest X Ray

A giant right coronary artery aneurysm (60 × 70 mm in size) was incidentally found by chest X-ray as an abnormal right atrial enlargement, and it needed surgical resection. Although the majority of giant coronary artery aneurysms present with symptoms of coronary ischemia, this case presented without any specific symptom. This study indicates that when chest X-ray shows abnormal atrial enlargement, a differential diagnosis of giant coronary artery aneurysm may need to be considered.

scholarly journals Giant Right Coronary Artery Aneurysm Associated with a Fistula Draining into the Superior Vena Cava

2016 ◽  
Vol 43 (4) ◽  
pp. 360-362 ◽  
Author(s):  
Ahmet Dolapoglu ◽  
David A. Ott
Keyword(s):  
Coronary Artery ◽  
Superior Vena Cava ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Superior Vena ◽  
Vena Cava ◽  
Artery Aneurysm ◽  
Giant Coronary Artery Aneurysm ◽  
Coronary Cameral Fistula ◽  
Artery Disease

Giant coronary artery aneurysm associated with a coronary–cameral fistula is an uncommon condition. Such aneurysms are usually associated with other cardiac diseases, such as coronary atherosclerosis, and therefore might augment myocardial ischemia in adults. The main indications for surgical intervention are severe coexisting coronary artery disease, evidence of embolization, and aneurysmal enlargement or rupture. We describe a large right coronary artery aneurysm and a coronary–cameral fistula that drained into the superior vena cava. The surgical repair was successful.

scholarly journals P259 Incidental giant Coronary artery aneurysm in the right coronary artery

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
E Cambronero Cortinas ◽  
P Moratalla-Haro ◽  
M Arzanauskaite ◽  
E Nyktari ◽  
R Mohiaddin
Keyword(s):  
Cardiac Surgery ◽  
Coronary Artery ◽  
Ejection Fraction ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Fistula Formation ◽  
Stress Perfusion ◽  
Giant Coronary Artery Aneurysm ◽  
History Of

Abstract Giant coronary artery aneurysm (CAAs) are unusual with reported incidence rate of 0.02% of patients who undergo cardiac surgery; often the proximal right coronary artery (RCA) is involved. They are defined as a localized area of dilatation exceeding 2cm in diameter. We report a case of an incidentally diagnosed partially thrombosed right CAA. A 69 years-old-male, with history of possible Marfan´s Syndrome and previously negative genetic study, was referred to the Cardiovascular Magnetic Resonance Unit for an outpatient assessment of his aortic dimensions. He had history of cardiac surgery with valve-sparing aortic root replacement, 15 years ago. Additionally, he had strong family history of sudden death probably related to acute aortic syndromes. The patient was asymptomatic, but interestingly during his most recent outpatient clinic appointment he reported an episode of chest pain 5 months before for which he called an ambulance but as the ECG only showed bradycardia, he was not taken to the hospital. Physical examination and routine blood test were irrelevant. The CMR study of the thoracic aorta showed an incidental aneurysmal dilatation of the proximal/mid RCA (diameter:40mm and length:60mm, Figure1:A). It was partially filled with a parietal thrombus. Biventricular ejection fraction was normal. CT angiogram confirmed the CMR findings (Figure1:B-C) and also showed ectatic LAD and distal RCA arteries. Myocardial stress perfusion scintigraphy exposed partial thickness infarction of the inferior and inferoseptal walls with a scar burden of 15% with additional mild superimposed ischaemia accounting to less than 5% of the myocardium. Coronary angiogram was then performed and due the complexity of the lesion and the high risk of embolization of thrombotic material in a patient with normal ejection fraction, the overall consensus was to treat him medically with anticoagulation, beta-blockers, ARE inhibitors and statins. CAAs are rare, occurring in 0.3% to 4.9% of patients undergoing coronary angiograms, while giant coronary artery aneurysms are even rarer. They are most commonly associated with male gender and hyperlipidemias. Atherosclerosis remains the most common cause of CAAs although they are also associated with congenital malformations, Kawasaki disease, autoimmune diseases (polyarteritis nodosa, lupus erythematosus and scleroderma), trauma, coronary artery dissection, rheumatic heart disease, mycotic coronary emboli, and syphilis, among others. In our case, comprehensive multimodality imaging led to the definitive diagnosis. Untreated CAAs may be complicated by ischaemia, myocardial infarction, distal embolization due to thrombus formation within the aneurysm, calcification, fistula formation and spontaneous rupture. Various surgical approaches to treat giant CAAs are reported in the literature, such us, excision of the aneurysm with bypass to the distal coronary artery. However, percutaneous intervention could be possible in some cases. Abstract P259 Figure 1.

scholarly journals A Case of Giant Coronary Artery Aneurysm in the Right Atrium Associated with a Right Coronary-Right Atrial Fistula

2004 ◽  
Vol 33 (5) ◽  
pp. 352-355
Author(s):  
Motohiro Oshiumi ◽  
Kazuhiro Hashimoto ◽  
Hiroshi Okuyama ◽  
Ryuichi Nagahori ◽  
Gen Shinohara ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Atrium ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Right Atrial ◽  
Giant Coronary Artery Aneurysm ◽  
The Right

A giant coronary artery aneurysm in the right coronary artery

2006 ◽  
Vol 15 (3) ◽  
pp. 150-152 ◽  
Author(s):  
Michael J. Collins ◽  
Aidan J. Borges ◽  
Gursharan Singh ◽  
Jain B. Pillai ◽  
Tirone E. David ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Giant Coronary Artery Aneurysm ◽  
The Right

scholarly journals Fistula occlusion and ligation for a giant right coronary artery aneurysm concurrent with right atrial fistula: a case report

BMC Surgery ◽  
2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yan Ren ◽  
Lin Xie ◽  
Weiqiang Ruan ◽  
Yajiao Li ◽  
Peng Ji ◽  
...  
Keyword(s):  
Cardiopulmonary Bypass ◽  
Coronary Artery ◽  
Blood Supply ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Right Atrial ◽  
Coronary Artery Ligation ◽  
Coronary Artery Aneurysms ◽  
Artery Ligation

Abstract Background Coronary artery aneurysms in most cases require surgical treatment once diagnosed. Lifelong anticoagulation is often needed after surgery. We herein describe a 55-year-old man who was asymptomatic and diagnosed with right giant coronary artery aneurysm combined with right atrial fistula. Case presentation This is a case of asymptomatic giant right coronary artery aneurysm concurrent with coronary artery fistula. Because the aneurysm was in the distal right posterior descending coronary artery, right coronary artery ligation and fistula occlusion through the right atrium were performed in the absence of cardiopulmonary bypass. The aneurysm was excluded without impacting the myocardial blood supply, and the patient was exempted from lifelong anticoagulation regimen. The follow-up revealed favorable outcomes and the patient’s life expectancy was improved. Conclusion Decompression and exclusion without cardiopulmonary bypass can be adopted for distal coronary artery aneurysms that do not involve or only have a limited impact on distal blood supply. This procedure can exempt the patient from the lifelong anticoagulation regimen. In addition, the risk for myocardial ischemia caused by the thrombus in the aneurysm can also be avoided. The whole procedure is comparatively easy to perform.

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