Left Main Coronary Artery Aneurysm Research Articles

Surgery for a giant atherosclerotic left main trifurcation saccular coronary artery aneurysm.

Aneurysms of the left main coronary artery are rare clinical entities with an incidence of 0.1%. We herein report a case of left main trifurcation aneurysm in a 57-year-old woman whose coronary angiography demonstrated a giant saccular aneurysm of trifurcation of the left main coronary artery, measuring 32 × 21mm with tight post-aneurysmal stenosis in the intermediate artery. The patient underwent coronary artery bypass grafting following the resection of CAA and reconstruction with saphenous vein roof-plasty, which ensured the preservation of the native coronary vasculature. At the 6-month follow-up, she remained asymptomatic and preserved preoperative left ventricular function.

Left Main Coronary Artery Aneurysm

Left Main Coronary Artery Aneurysm

Anomalous Great Cardiac Vein Mistaken for Left Main Coronary Artery Aneurysm in a Case of Anomalous Left Coronary Artery Arising from the Main Pulmonary Artery

Abstract Anomalous coronary venous drainage is rare and likely to be under-reported, with many cases found incidentally in cardiac imaging and autopsy studies. It may also occasionally have an important clinical implication. We report a rare case of anomalous great cardiac vein bypassing the coronary sinus to drain directly into the left brachiocephalic vein in a patient with anomalous left coronary artery arising from the main pulmonary artery. This anomalous course resulted in a misdiagnosis of coronary aneurysm on echocardiography.

Left Main Coronary Artery and Bilateral Mammary Artery Aneurysms in a Patient With Extensive Aortopathy.

Left Main Coronary Artery and Bilateral Mammary Artery Aneurysms in a Patient With Extensive Aortopathy.

Incidental Finding of a Giant Left Main Coronary Artery Aneurysm as an Anterior Mediastinal Mass.

Incidental Finding of a Giant Left Main Coronary Artery Aneurysm as an Anterior Mediastinal Mass.

Hybrid Treatment for a Distal Left Main Coronary Artery Aneurysm ― Coronary Artery Bypass Grafting and Surgical Ligation Followed by Intraoperative Covered Stent Implantation ―

Hybrid Treatment for a Distal Left Main Coronary Artery Aneurysm ― Coronary Artery Bypass Grafting and Surgical Ligation Followed by Intraoperative Covered Stent Implantation ―

Left main coronary artery aneurysm: a rare case report

Left main coronary artery (LMCA) aneurysm is a rare condition and the treatment strategy has not been fully determined. Although usually asymptomatic, myocardial ischemia or infarction may develop or rupture. Antiaggregant therapy should be given to prevent thrombus formation. In appropriate cases, percutaneous methods or surgical strategies can be successfully applied, especially in the case of concomitant coronary artery disease (CAD). We present a case of coronary artery bypass surgery performed on a patient with concurrent critical CAD with an aneurysm distal to the LMCA and proximal to the left anterior descending artery.

Coronary cameral fistula with left main coronary artery aneurysm: A challenging case

Coronary cameral fistula with left main coronary artery aneurysm: A challenging case

Giant Aneurysm of Left Main Coronary Artery in a Patient With Prior Operation for 4-Valve Endocarditis

Left main coronary artery aneurysm is an unusual complication of infective endocarditis. Although this type of aneurysm is often asymptomatic, rupture and thrombus formation that result in myocardial infarction are known complications; therefore, prompt recognition and surgical intervention are warranted. This report describes a patient who presented with a giant left main coronary artery aneurysm 3.5 years after being treated for 4-valve endocarditis. The management and technical aspects of this challenging case are discussed here.

Giant left main coronary artery aneurysm

Introduction. Coronary artery aneurysms (CAAs) are rare disorders, especially the left main CAA. In the literature, there are several reported cases with CAAs, various localization, size, clinical presentation, and way of treatment. There is no unique consensus about the most adequate treatment for these patients; however, surgery is still preferable, although there are some new experiences of percutaneous treatment. The decision is made for each patient individually. We report a case of giant left main CAA, with acute coronary syndrome and heart failure presentation, surgically treated. Case report. A 66-year-old female patient was admitted to the emergency department of our clinic due to chest pain and dyspnea. Acute non-ST-elevation segment myocardial infarction (STEMI) of anterolateral localization was diagnosed (creatine kinase max 1,111 U/L, troponin T 3.754 ng/mL), complicated with acute heart failure. Heart catheterization and coronary angiography revealed a giant saccular, 3.5 ? 3.5 mm left main CAA full with thrombi, compressing the proximal segments of the left anterior descending and circumflex artery. Conclusion. Giant left main CAAs are rare pathologic findings, and there are no established principles for treatment. Although the percutaneous way of treatment is now available in selected cases, the surgical approach is still preferred for these patients.

An Incidental Discovery of a Left Main Coronary Artery Aneurysm

The left main coronary artery aneurysm is a rare disease caused mainly by atherosclerosis. It is usually an incidental finding during coronary angiography but can manifest itself with ischemic heart disease symptoms. In our paper, we present the case of a polyvascular patient who benefited from a coronary angiography in the context of the etiological workout of his dilated cardiomyopathy, which lead to the discovery of a large left main coronary artery aneurysm associated with two-vessel coronary disease. Through our paper, we aim to discuss the different aspects of this condition and its different treatment options.

Etiology, clinical presentation, and management of left main coronary artery aneurysms

The widespread use of noninvasive/invasive coronary imaging increased the probability of recognition of coronary aneurysms. Left main coronary aneurysms (LMCA), though rare, are potentially life-threatening but in the absence of controlled studies, guidelines do not provide any specific recommendation for their management. We, therefore, aimed to investigate the epidemiology, clinical presentation, therapeutic strategies, and prognostic implication of LMCA. A systematic review of the literature was performed to retrieve all the reported cases of LMCA as of December 2021, which were summarized and classified according to their etiology, clinical presentation, and therapeutic management. Out of 1997 works retrieved, 180 studies were analyzed, describing 209 LMCA cases (aged 51 ± 19 years, 68% males). Atherosclerosis was the most common etiology (40%), followed by inflammatory (12%), congenital (9%), or degenerative (6%) conditions. Stable angina (43%) and acute coronary syndromes (32%) were more often the first clinical manifestations, while 29 (14%) LMCA were incidental findings. Most cases were treated surgically (53%), while percutaneous intervention was rarely adopted (7%). Data about antithrombotic therapies were scarce and heterogeneous. Finally, when longitudinal data were reported (n = 81), LMCA resulted associated with a severe prognosis, with a 15% mortality over an 8-month median follow-up. LMCA are most frequently, but not exclusively, caused by advanced atherosclerosis. Irrespective of their etiology and clinical presentation, LMCA may be associated with high short-term mortality. In absence of controlled studies, a careful evaluation of each case is warranted to optimize therapeutic strategies.

Left main coronary artery aneurysms: Rare but potentially lethal occurrences.

Left main coronary artery aneurysms: Rare but potentially lethal occurrences.

Lateral wall ischemia secondary to funnel-shaped left main coronary artery aneurysm with stenotic osteoproximal left circumflex coronary artery in a child with recent recovery from kawasaki disease: A case report and review of literature

Lateral wall ischemia secondary to funnel-shaped left main coronary artery aneurysm with stenotic osteoproximal left circumflex coronary artery in a child with recent recovery from kawasaki disease: A case report and review of literature

Percutaneous closure of a left main coronary artery aneurysm

A 56-year-old women without a coronary past presented to the emergency room with complaints of typical persistent chest pain. The electrocardiogram showed negative T waves in anterior leads, and th...

Vasculitis of Vasa Vasorum and Aneurysm Formation in Kawasaki Disease: Predilection for Coronary Arteries Lesions

<i>Backgrounds</i>. The mechanism causing coronary artery lesions in Kawasaki disease (KD) has not yet been fully clarified. <i>Objective</i>. We hypothesized that the main coronary artery (MCA) segment perfused by the vasa vasorum (VV) arose from the atrial and ventricular branches of peripheral coronary arteries in the myocardium (Type 1 VV externa) is more prone to aneurysm formation than that perfused by Type 2 VV originated from the ostium. <i>Methods and Results</i>. We reviewed the coronary angiography and two-dimensional echocardiogram (2DE) data of KD patients in our hospital and measured the distances from the left coronary ostium to the proximal point of the aneurysm in the left MCA (D1) and to the MCA bifurcation (D2). We found that the ratio of the distances (D1/D2) was negatively correlated with the patients’ age of KD onset, indicating that longitudinal extension of the left MCA aneurysms coincided with the development of Type 1 VV externa. We performed a literature review of KD cases with extracardiac aneurysms and found that 15 patients also had giant aneurysms in the MCA. Also, 8 of 9 extracardiac aneurysm cases whose clear 2DE images were available in the reports, the giant MCA aneurysms seemed to have developed at positions immediately adjacent to the ostium. We assume that the giant coronary aneurysms might be a consequence of the coincidence of aneurysms in the MCA segments perfused by Type 1 and 2 VV externas and reflect a severe inflammation where Type 2 VV externa which is less susceptible to blood flow reduction than Type 1 VV externa is affected. <i>Conclusions</i>. Vasculitis in VV externa with the unique structure originating from and distributing most richly across coronary arteries might induce a vicious circle of hypoperfusion of VV externa and reduced coronary blood flow.

Left Main Coronary Aneurysm: A Rare but a Serious Cause of Acute Myocardial Infarction

Left main coronary artery (LMCA) aneurysms are rare with incidence of 1 in 1000 cases among patients undergoing coronary angiography. Coronary artery aneurysm is defined as coronary arterial segment dilation > 1.5 fold greater than normal adjacent coronary segments. Atherosclerosis is the primary cause of coronary aneurysms but also has been reported in other conditions like arterial vasculitis (e.g., Kawasaki disease, Takayasu arteritis), or infection (e.g., syphilis, mycosis). LMCA aneurysms are especially associated with serious complications including thrombosis, distal embolization, spontaneous rupture or dissection or even sudden cardiac death. The optimal treatment for LMCA aneurysm is still controversial and the available results have been based mainly on case reports and not on controlled trials. The lack of consensus about managing LMCA is not the only challenge here. The lack of individualized treatment or precision medicine in this area makes managing these cases at bedside even more challenging.

Internal thoracic artery patch repair of a saccular left main coronary artery aneurysm

BackgroundA saccular aneurysm located at the bifurcation of the left main coronary artery (LMCA) is an extremely rare condition. A major cause of left main coronary aneurysm is atherosclerosis, and common complications include thrombosis, embolism, and rupture. Despite the serious nature of this condition, the ideal operative approach to LMCA aneurysm (LMCAA) has not been established. Furthermore, little is known about resection of the saccular aneurysm and closure using a small internal thoracic artery patch.Case presentationHere, we present the case of a 66-year-old woman who had significant stenosis in the left anterior descending artery and a saccular aneurysm at the bifurcation of the LMCAA, which was repaired using a small internal thoracic artery patch during coronary artery bypass grafting. Postoperative multislice computed tomography revealed the complete disappearance of the aneurysm and a successful repair with no luminal stenosis of the internal thoracic artery patch. In addition, the left internal thoracic artery graft was found to be patent.ConclusionsResection of the saccular LMCA aneurysm and closure using a small internal thoracic artery patch is safe and offer excellent results.

Left main coronary artery aneurysm - A slumbering giant

Left main coronary artery aneurysm - A slumbering giant

Therapeutic dilemma: Giant left main coronary artery aneurysm in patient with untreated Kawasaki disease

Therapeutic dilemma: Giant left main coronary artery aneurysm in patient with untreated Kawasaki disease