Successful sparing approach between the ascending aorta and the main pulmonary artery to the giant coronary aneurysm of the left main coronary artery

Abstract

Coronary aneurysm located just above the left main coronary artery (LMT) is rare and difficult to treat. How the aneurysm is accessed is very important as it determines the result of the surgery. A 70-year-old man with a large coronary aneurysm (40 mm in diameter) in the LMT underwent surgery to prevent its rupture; however, there was severe adhesion. Initially, dissection of the ascending aorta or the pulmonary artery seemed necessary to access the aneurysm; however, the process was possible with limited dissection between the ascending aorta and the pulmonary artery, and we succeeded in firmly closing the LMT site of entry.

Reconstruction of a left main coronary artery aneurysm using a radial artery patch

“…A coronary artery aneurysm (CAA) is described as an abnormal dilatation of a coronary artery segment. The prevalence of CAAs ranges from 0.3% to 0.53% [ 1 ] of the population who undergo left heart catheterization. Left main coronary artery aneurysms are the least common, found in 0.1% of those patients who undergo cardiac catheterization [ 2 ].…”

“…Some case studies reported temporary transection of the main pulmonary artery to assess the aneurysm [ 4 , 5 ]. Extensive dissection between the aorta and pulmonary artery may be necessary [ 1 ]. Most case studies that describe surgical repair report aneurysm ligation with bypass to a distal target.…”