Combination therapy for adult coronary artery aneurysm with off-pump coronary artery bypass grafting and vein graft-coated stent.
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We report on a 51-year-old Japanese female with bilateral coronary artery aneurysms. Severe calcified aneurysms were detected in the proximal right coronary artery (RCA) and left anterior descending branch (LAD). The RCA was totally occluded and supplied by the blood flow via septal branches of the LAD. A two-stage management plan, including an off-pump coronary artery bypass grafting for the RCA with a right gastroepiploic artery and catheter angioplasty with an autologous vein graft-coated stent for the LAD, was successfully completed. Prophylactic treatments for coronary artery aneurysm are still controversial, therefore, minimal invasive procedures should be favored to prevent acute cardiac shock or sudden death related to aneurysmal obstruction. (+info)
Magnetic resonance angiography is equivalent to X-ray coronary angiography for the evaluation of coronary arteries in Kawasaki disease.
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OBJECTIVES: The purpose of this study was to compare the results of magnetic resonance angiography (MRA) with X-ray coronary angiography (XCA) in a pediatric population. BACKGROUND: Coronary artery abnormalities in Kawasaki disease (KD) develop in about 15% to 25% of young patients, mostly in the form of aneurysms. METHODS: Thirteen patients (12 male), age three to eight years, were studied. The maximal diameter and length of the aneurysm were recorded. Coronary MRA was performed using a 1.5 T Philips Intera CV magnetic resonance scanner with an electrocardiographically triggered pulse sequence. It was a three-dimensional segmented k-space gradient-echo sequence (TE = 2.1 ms, TR = 7.5 ms, flip angle = 30 degrees, slice thickness = 1.5 mm) employing a T2-weighted preparation pre-pulse and a frequency selective fat-saturation pre-pulse. Data acquisition was performed in mid-diastole. All scans were carried out with the patient free breathing using a two-dimensional real-time navigator beam. All patients underwent XCA within a week. RESULTS: In six patients, aneurysms of the coronary arteries were identified, while coronary ectasia alone was present in the remaining seven patients. Magnetic resonance angiography and XCA diagnosis of coronary artery aneurysm agreed completely. Maximal aneurysm diameter and length and ectasia diameter by MRA and XCA were similar. No stenotic lesion was identified by either technique. CONCLUSIONS: In conclusion, MRA is a reliable diagnostic tool, equivalent to XCA for coronary artery aneurysm identification in patients with KD. Magnetic resonance angiography may prove to be of great value for the serial non-invasive evaluation of these patients. (+info)
Spontaneous rupture of a coronary artery aneurysm: a case report and review of the literature.
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Coronary artery aneurysm (CAA) is a rare disorder, characterized by abnormal dilatation of a localized portion or diffuse segments of the coronary artery. CAA may cause angina, myocardial infarction, sudden death due to thrombosis, embolisation, or rupture. In this report, a 63 year old Turkish male patient is presented who had an acute non-Q wave myocardial infarction due to spontaneous rupture of the left circumflex artery aneurysm. An extremely rare clinical presentation of rupture of a left circumflex CAA is discussed. (+info)
AIMS: To discuss the diagnosis of giant coronary aneurysms. METHODS AND RESULTS: We describe three patients in whom initial echocardiographic findings suggested cardiac tumors in the right atrium. Additional examination proved the tumor-like structures to be giant atherosclerotic coronary aneurysms of either the right coronary artery or its saphenous vein coronary bypass graft. CONCLUSION: Giant coronary aneurysms are an important differential diagnosis for cardiac tumors. (+info)
Giant right coronary artery aneurysm presenting as a mediastinal mass.
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Coronary artery aneurysms are commonly of atherosclerotic origin and are frequently asymptomatic. However, they may have varied presentations including angina, myocardial infarction, and sudden death. A case of a giant right coronary artery aneurysm presenting with acute myocardial infarction is presented, where the aneurysm appeared to be a mediastinal mass on transthoracic and transoesophageal echocardiography. Although computed tomography and magnetic resonance imaging of the heart suggested the correct diagnosis, definitive proof came from coronary angiography. Coronary artery aneurysms should be considered in the differential diagnosis of mediastinal masses. (+info)
Spontaneous coronary artery dissection in the postpartum period: association with antiphospholipid antibody.
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Spontaneous coronary artery dissection (SCAD) is an extremely uncommon cause of myocardial infarction, occurring predominantly in women during or after pregnancy. The exact aetiology is unknown. This report describes a 33 year postpartum woman with diagnosed SCAD who tested positive for anticardiolipin antibody. This is the first case of SCAD in a patient with antiphospholipid antibody. The authors hypothesised that there should be a strong association between them. (+info)
Emergent operation for aneurysm of the left main coronary artery presenting acute myocardial infarction.
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We report an emergent operation on a 37-year-old man presenting with acute myocardial infarction with an aneurysm of the left main coronary artery. A preoperative coronary angiogram revealed a large saccular aneurysm of the left main coronary artery and complete occlusion of the left anterior descending artery. Emergent coronary artery bypass graftings to the left anterior descending artery with the left internal thoracic artery and the circumflex artery with the saphenous vein were performed, followed by the ligation and exclusion of the aneurysm of the left main coronary artery. The postoperative course was uncomplicated and the patient did well. Although the etiology of the aneurysm was not investigated, it was suspected to be a congenital aneurysm. (+info)
A case of the coronary artery aneurysm including stent device after percutaneous coronary intervention.
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We presented a case of left anterior descending coronary artery aneurysm that was developed after percutaneous coronary intervention (PCI) with stent implantation. The aneurysm was plicated after removal of the stent device, and the left descending coronary artery was bypassed with the left internal thoracic artery. Few have reported surgical treatments for the coronary aneurysm including PCI stent. In this report, a patient requiring PCI stent explantation was described and technical considerations for this patient were discussed. (+info)