Clinical Characteristics and Surgical Outcomes of Coronary Artery Aneurysm: A Case Series

Abstract

Background: Coronary arteries aneurysm (CAA) is one the rare and life-threatening abnormalities of the cardiovascular system. Objectives: Our study aims to present clinical characteristics and surgical results of patients with aneurysm of coronary artery in Iranian population. Methods: This is a retrospective case series of eight patients with aneurismal coronary artery, who underwent surgical repair in an Iranian tertiary referral centre from 2004 - 2014 and were followed up till 2017 (mean follow-up: 8.6 ± 3.8 years). Patients’ demographics, clinical characteristics, past medical histories and surgical data were recorded retrospectively. All data were analyzed by SPSS software (IBM Corp. IBM SPSS Statistics for Windows, version 22.0. Armonk, NY: IBM Corp.). Results: Overall eight patients with CAA, consisting of 6 (75%) male and mean age of 35.21 ± 23.76 (0.75 - 67) years, were analyzed. Dyspnea and chest pain were the most frequent symptoms among patients (3 (37.5%)). Moreover, hypertension and coronary artery disease (CAD) were the most common comorbidities amongst our subjects. Angiography of patients showed concomitant CAD in 6 (75%) patients including four (50%) three-vessel disease and two (25%) two-vessel disease. Left anterior descending (LAD) was the most prevalent aneurismal coronary artery 4 (50%). Six (75%) patients underwent coronary artery bypass graft (CABG) at the same time due to coronary artery disease. One patient had post operative bleeding and underwent re-operation and 2 patients had pericardial effusion that didn’t require surgical intervention. There was no perioperative MI, respiratory problems, acute kidney insufficiency (AKI), infections and in-hospital or late mortalities in patients after surgery. Conclusions: Majority of patients diagnosed and treated for CAA, had concomitant coronary artery disease at the time of testing and underwent CABG. There were no peri and post-operative mortality, and all patients showed satisfying outcome. In addition to the benefits of early diagnosis and intervention in prognosis of patients, larger studies are warranted to identify the possible risk factors of this condition to identify those at risk in order to reduce the consequent complications.