Giant Right Coronary Artery (RCA) Aneurysm

2013 ◽  
Vol 16 (3) ◽  
pp. 167
Author(s):  
Abdurrahim Colak ◽  
Munacettin Ceviz ◽  
M. Hakan Tas ◽  
Hayri Ogul
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Coronary Bypass ◽  
Rare Type ◽  
Artery Disease ◽  
The Right

Coronary artery aneurysm (CAA) is a rare type of coronary artery disease. The angiographic incidence of the coronary artery aneurysm is reportedly between 1.5% to 4.9%, and it is more frequent in men. We have successfully carried out a simultaneous “coronary bypass together with aneurysm ligation” operation on a patient with coronary heart disease and an aneurysm within the right coronary artery.

Giant right coronary artery aneurysm

2020 ◽  
Vol 28 ◽  
pp. 1-3
Author(s):  
Alexandre Bonfim ◽  
Ronald Souza ◽  
Sérgio Beraldo ◽  
Frederico Nunes ◽  
Daniel Beraldo
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Clinical Course ◽  
Artery Aneurysm ◽  
Giant Aneurysm ◽  
Coronary Artery Aneurysms ◽  
History Of ◽  
Artery Disease ◽  
The Right

Right coronary artery aneurysms are rare and may result from severe coronary disease, with few cases described in the literature. Mortality is high, and therapy is still controversial. We report the case of a 72-year-old woman with arterial hypertension, and a family history of coronary artery disease, who evolved for 2 months with episodes of palpitations and dyspnea on moderate exertion. During the evaluation, a giant aneurysm was found in the proximal third of the right coronary artery. The patient underwent surgical treatment with grafting of the radial artery to the right coronary artery and ligation of the aneurysmal sac, with good clinical course.

A covered rupture of a giant right coronary artery aneurysm in the right atrium wall

2014 ◽  
Vol 174 (3) ◽  
pp. e120-e121 ◽  
Author(s):  
Carlo Banfi ◽  
André Vincentelli ◽  
Pierre-Vladimir Ennezat ◽  
Marco Midulla ◽  
Merie Alibrahim ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Right Atrium ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
The Right

scholarly journals Multi-Vessel Coronary Artery Disease: Choice of Myocardial Revascularization Strategy

2020 ◽  
Vol 27 (4) ◽  
pp. E202041
Author(s):  
Nestor Seredyuk ◽  
Andrii Matlakh ◽  
Yaroslava Vandzhura ◽  
Mykyta Bielinskyi ◽  
Oleksii Skakun ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Right Coronary Artery ◽  
Myocardial Revascularization ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease ◽  
The Right

Multi-vessel coronary artery disease is quite a common state, which is often diagnosed by coronary angiography in patients with both stable coronary artery disease and acute coronary syndromes. Major difficulties in percutaneous coronary intervention include stent thrombosis and the need for antiplatelet therapy (aspirin and a P2Y12 inhibitor). Stent thrombosis leads to the recurrence of myocardial infarction and may occur within the first few hours after percutaneous coronary intervention. The use of dual antiplatelet therapy, especially that combined with low-molecular-weight heparin in the first days after myocardial infarction, poses a risk of bleeding, which often occurs in real clinical practice. Among P2Y12  inhibitors, ticagrelor causes bleeding somewhat more frequently than clopidogrel. A case of multi-vessel coronary artery disease is described in this paper. Coronary angiography revealed right-dominant circulation; occlusion of the proximal and medial segments of the right coronary artery, thrombolysis in myocardial infarction flow grade 0; stenosis of the left main coronary artery (50-60%), thrombolysis in myocardial infarction flow grade 2; diffuse stenosis of the medial and distal segments of the left anterior descending artery, thrombolysis in myocardial infarction flow grade 1; stenosis of the proximal segment of the left circumflex artery (> 75%), thrombolysis in myocardial infarction flow grade 1. The patient underwent percutaneous coronary intervention; the stents were implanted in the infarct-dependent right coronary artery. The clinical course was complicated by early stent thrombosis with subsequent thrombus extraction; a day later melena developed. Bleeding was stopped, the intensity of antithrombotic therapy was reduced: the combination of aspirin and ticagrelor was replaced by the combination of aspirin and clopidogrel. Six weeks after stenting of the infarct-dependent coronary artery, complete myocardial revascularization (hybrid intervention) was performed: coronary artery bypass grafting [the left internal mammary artery → the left anterior descending artery], coronary autogenous bypass grafting [the aorta → the right coronary artery and the aorta → the left circumflex artery]. The role of fractional flow reserve or instantaneous wave-free ratio-controlled complete myocardial revascularization techniques is discussed. The following algorithm for myocardial revascularization was used: percutaneous coronary intervention for the right coronary artery + coronary artery bypass grafting-3: the left internal mammary artery → the left anterior descending artery, the aorta → the left circumflex artery, the aorta → the right coronary artery.

scholarly journals Giant Coronary Artery Aneurysms Involving More Than One Coronary Artery

2021 ◽  
Author(s):  
Matthew S Khouzam ◽  
Nayer Khouzam
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Aortic Aneurysm ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Artery Aneurysm ◽  
Coronary Artery Aneurysms ◽  
St Segment ◽  
History Of ◽  
The Right

Abstract Background: Coronary artery aneurysms are rare findings in patients undergoing coronary angiography. The presence of multiple coronary artery aneurysms located in more than one coronary artery is even more uncommon. The pathophysiology of such aneurysms is unknown, but the majority are often due to atherosclerosis, congenital heart disease, or vasculitis. Case Presentation: We present a rare case of a 78-year-old female patient who presented with unstable angina and non-ST segment elevation myocardial infarction. On coronary angiography she was found to have three separate 1 cm saccular aneurysms involving the proximal left anterior descending coronary artery. The right coronary artery could not be visualized. Computed chest tomography revealed a 6.6 x 6.3 cm saccular aneurysm of the right coronary artery, and a 4.4 cm fusiform aneurysm of the ascending aorta. The patient gave no history of percutaneous coronary intervention or cardiac surgical procedures. She had a previous history of endovascular stenting of an abdominal aortic aneurysm. The sizable right coronary artery aneurysm showed extrinsic compression of both the right atrium and ventricle with right ventricular hypokinesis. Serological studies for vasculitis were all negative. Pathology of the aneurysm wall revealed calcific atherosclerosis without evidence of vasculitis. The patient underwent subtotal resection of the right coronary aneurysm with ligation of the proximal and distal ends of the right coronary artery and double bypass surgery to the left anterior descending and right posterior descending coronary arteries. Conclusion: The presence of multiple, large coronary artery aneurysms is very rare. Treatment can be challenging and should be individualized. Surgical treatment is recommended for giant coronary artery aneurysms to prevent potential complications. Keywords: coronary artery aneurysm, aortic aneurysm, atherosclerosis, non-ST segment 32 elevation myocardial infarction, case report

scholarly journals Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
James Barr ◽  
Metesh Nalin Acharya ◽  
Antonios Kourliouros ◽  
Shahzad Gull Raja
Keyword(s):  
Coronary Artery ◽  
Right Coronary Artery ◽  
Coronary Artery Aneurysm ◽  
Surgical Repair ◽  
Saphenous Vein Graft ◽  
Artery Aneurysm ◽  
Coronary Artery Aneurysms ◽  
Coronary Aneurysms ◽  
Right Ventricular Strain ◽  
The Right

Giant coronary artery aneurysms are rare clinical entities. We report the case of a 49-year-old man who presented with dyspnoea and exertional chest pain. Investigations confirmed an aneurysmal right coronary artery measuring 4 cm with a fistulous communication to the right atrium. Following right atriotomy, the fistula was oversewn and the aneurysmal right coronary artery ligated at its origin and at several points along its course. A saphenous vein graft was anastomosed to the posterior descending artery. Persistent ventricular fibrillation occurred upon chest closure, attributed to ischaemia following ligation of the aneurysmal coronary artery. Emergent resternotomy and internal defibrillation were successfully performed. The sternum was stented open to reduce right ventricular strain and closed the following day. The patient made an unremarkable recovery. We here address the technical challenges associated with surgical repair of right coronary aneurysms and the physiology and management of potential complications.

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