Combined Surgical Approach to Multiple Giant Coronary Artery Aneurysms

Abstract

Multiple giant coronary artery aneurysms are rare but can develop in the presence of an underlying atherosclerotic vessel disease. Nevertheless, there is no consensus on the ideal surgical treatment or on operative procedures, including aneurysm resection, ligation, distal bypass, and graft interposition. We present the case of a 72-year-old woman with a history of multiple arterial aneurysms who was admitted to the emergency clinic with sudden-onset chest pain and dyspnea. The patient's diagnosis was ischemic heart disease and multiple giant coronary artery aneurysms involving the left anterior descending coronary artery and the proximal and distal segments of the right coronary artery. We present a combined surgical approach to multiple giant coronary artery aneurysms associated with atherosclerosis.

Impairment of tricuspid annular plane systolic excursion and tricuspid annular peak systolic velocity after arterial switch operation

“…This age dependence does not affect the main conclusion of our article, the persistent impairment of RV performance, because age-matched controls were used for this analysis. We agree with Koestenberger and colleagues, however, that transformation of TAPSE and RV S 0 from absolute values to z scores, as previously defined, 3,4 could yield additional insights into the changes observed in RV performance after the arterial switch operation.…”

“…Furthermore, all RV performance parameters remained impaired in patients relative to control subjects 9 months postoperatively. For the convenience of Journal readers, we would like to mention that a comparison of their TAPSE and S 0 data with available TAPSE and S 0 normal values and z scores 4,5 would have improved the statistical power of their analysis.…”

Two Cases of Multivessel Coronary Artery Ectasias Resulting in Acute Inferior Myocardial Infarction

“…Multivessel coronary artery aneurysms are rare, but can develop in the presence of underlying atherosclerotic vessel disease 8). The diagnosis of MCAA occurs frequently in patients suspected of angina pectoris or myocardial infarction secondary to thrombosis with the aneurysm leading to total occlusion or distal embolization as presented in our cases 4)9).…”

Various surgical approaches to coronary artery aneurysm

“…In this technique, to avoid of bleeding from the suture line or occlusion caused by traction on the LAD, we mobilized the LAD sufficiently and checked for any resulting tension after the anastomoses. 4 The resection and end-to-end anastomosis technique can be applied with confidence and is a feasible choice among all the available techniques. Furthermore, this technique is advantageous because of native-to-native coronary anastomosis.…”