Large multiple coronary artery aneurysm in adult patients: a report on three patients and a review of the literature

Letac, B; Cazor, J. L.; Cribier, Alain; C, Sibille; Toussaint, C.

doi:10.1016/0002-8703(80)90617-1

Cited by 29 publications

(13 citation statements)

References 33 publications

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“…1 Although the febrile course of the illness is self-limited, approximately 2% of affected individuals die of cardiac complications, particularly myocardial infarction secondary to coronary artery thrombosis.13 The age distribution of the disorder peaks during the first two years of life, with 80% of patients younger than age 4 years.2 Adult KS has received increased recognition, but has been chal¬ lenged on the basis that early reports of adult cases probably represented toxic shock syndrome (TSS). 25 The diagnosis of KS is dependent on the presence of five of six clinical criteria and the exclusion of other possible causes of the illness. The criteria include: (1) fever lasting for five or more days; (2) conjunctival congestion; (3) oropharyngeal mucosal inflammation manifested by either diffuse erythe-ma, strawberry tongue, or erythematous, dry, fis¬ sured lips; (4) changes in the peripheral extremities manifested by either induration or edema of the hands and feet, palmar and/or plantar erythema, desquamation of the fingers and/or toes, or the development of Beau's lines on the nails; (5) diffuse erythematous rash; and (6) cervical lymphadenopathy greater than 1.5 cm.…”

mentioning

confidence: 99%

Adult Kawasaki Syndrome

Butler

Hough²,

Friedman³

et al. 1987

Arch Dermatol

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Kawasaki syndrome (KS) is an idiopathic, acute, febrile, exanthemous illness that primarily affects infants and children. We describe a 20-year-old black woman who fulfilled the clinical criteria for the diagnosis of KS and excluded other possible causes. In addition, we reviewed data on 21 patients with adult KS reported in the English literature and accepted ten cases as representing this syndrome. The epidemiologic, clinical, laboratory, and pathologic features of the 11 cases representing adult KS are discussed. Although the initial reports of adult KS in the United States may have actually represented toxic shock syndrome, the occurrence of KS in adults should be acknowledged.

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mentioning

confidence: 99%

Adult Kawasaki Syndrome

Butler

Hough²,

Friedman³

et al. 1987

Arch Dermatol

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“…With very limited information about this potentially severe and complex disease, the only data available are based on clinical cases, small series, or post‐hoc substudies from other research, usually noncontemporary, with different profiles and probably different therapeutics . Thus, when diagnosing a coronary aneurysm (acutely or not), there is no clear therapeutic approach and prognostic data.…”

Section: Discussionmentioning

confidence: 99%

Rationale and design of a multicenter, international and collaborative Coronary Artery Aneurysm Registry (CAAR)

Núñez‐Gil

Nombela‐Franco

Bagur

et al. 2017

Clinical Cardiology

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Coronary artery aneurysm is defined as a coronary dilation that exceeds the diameter of adjacent segments or the diameter of the patient's largest normal coronary vessel by 1.5×. It is an uncommon disease that has been diagnosed with increasing frequency since the widespread appearance of coronary angiography. The published incidence varies from 1.5% to 5%, suggesting male dominance and a predilection for the right coronary artery. Although several causes have been described, atherosclerosis accounts for ≥50% of coronary aneurysms in adults. Reported complications include thrombosis and distal embolization, rupture, and vasospasm, causing ischemia, heart failure, or arrhythmias. The natural history and prognosis remain unknown, as definitive data are scarce. Controversies persist regarding the use of medical management (antithrombotic therapy) or interventional/surgical procedures. Only some case reports or small case series are available about this condition. The Coronary Artery Aneurysm Registry (CAAR; http://www.ClinicalTrials.gov NCT02563626) is a multicenter international ambispective registry that aims to provide insights on anatomic, epidemiologic, and clinical aspects of this substantially unknown entity. In addition, the registry will assess management strategies (conservative, interventional, or surgical) and their short‐ and long‐term results in a large cohort of patients. Clinical Trial registration: http://ClinicalTrials.gov. Unique identifier: NCT02563626.

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“…Congenital aneurysms are usually large 1,2 and situated on one coronary artery, generally the right coronary. 1 Atherosclerotic aneurysms are usually small. 1 When surgical treatment should be performed for coronary aneurysm is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…1 Atherosclerotic aneurysms are usually small. 1 When surgical treatment should be performed for coronary aneurysm is controversial. Coronary aneurysms of at least three to four times the original vessel diameter are an absolute indication for operation.…”

Section: Discussionmentioning

confidence: 99%

Giant aneurysm of the right coronary artery and fistula to the coronary sinus

Komoda

Ivanitskaia-Kuehn

et al. 2010

Gen Thorac Cardiovasc Surg

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We describe the case of a 67-year-old man with a rare combination of a giant coronary artery aneurysm with a fistula draining into the coronary sinus. The patient presented with a sensation of retrosternal pressure. He was examined by coronary angiography, which revealed a large aneurysm of the right coronary artery (RCA) with a fistula. This fistula originated from the distal RCA shortly beyond the crux and drained into the coronary sinus. The aneurysm was in the proximal portion of the RCA, measuring 4 cm in diameter and 7 cm in length. Surgical repair by closure of the fistula under direct vision, suture closure and plication of the aneurysm, and coronary artery bypass was performed. Postoperative echocardiography and computed tomography confirmed closure of the fistula. The patient remains symptom-free at 4 months after surgery.

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Large multiple coronary artery aneurysm in adult patients: a report on three patients and a review of the literature

Cited by 29 publications

References 33 publications

Adult Kawasaki Syndrome

Adult Kawasaki Syndrome

Rationale and design of a multicenter, international and collaborative Coronary Artery Aneurysm Registry (CAAR)

Giant aneurysm of the right coronary artery and fistula to the coronary sinus

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