Surgical management of an atherosclerotic aneurysm of the left main coronary artery

Coronary artery aneurysm: A review

“…1 Because of the rarity of LMCA aneurysm, it is difficult to standardize treatment. 13 Anticoagulation with warfarin is advocated for therapy for LMCA aneurysm; however, compared with platelet adhesion inhibitor, the benefit of this therapy is not known. 14 There are also few reports of surgical treatment of LMCA aneurysms.…”

“…Coronary bypass graft with ligation of the aneurysm is an alternative surgical treatment for aneurysms of the LMCA. 13 Intracoronary thrombolytic agents for angiographically evident thrombi have also been used, but the long-term result is unclear. 14 In Kawasaki disease, the U.S. multicenter study observed a reduced incidence of aneurysms and ectasia from 23 to 5% and giant aneurysms from 5 to 1% when intravenous immunoglobulin (IVIG) is given within 10 days of occurrence.…”

“…11 In addition, CAE may be associated with concomitant aneurysms in different arterial beds. 12 Multiple CAEs in childhood and adolescence are usually late complications of Kawasaki disease, 13 which is an acute febrile illness occurring during infancy (usually before 5 years of age) and is associated with cervical lymphadeopathy, rash, and a "strawberry tongue." In survivors of Kawasaki disease, even if asymptomatic, large CAEs may be present and are frequently associated with significant CAD and even coronary occlusions.…”

Three Year Follow-Up of a Vein Patch Repair for a Coronary Artery Saccular Aneurysm of the Left Main Bifurcation

“…7,8) While left main coronary artery aneurysms were treated by CABG alone without any intervention for the aneurysm in the early stages, they are treated by ligation or resection of the aneurysms in addition to CABG in the late stages because there is a risk of thrombosis, rupture, or coronary arterial embolization. 9) In this present case, a higher risk of rupture was conceivable than usual because of the aneurysmal form "saccular type" and the extremely thin wall. 10) The pathological findings of the aneurysm revealed very thin aneurysmal wall with a collapsed trilaminar arterial structure.…”

Patch Angioplasty for a Left Main Coronary Artery Pseudoaneurysm following Percutaneous Coronary Intervention

“…The most common surgical technique may involve ligation of an aneurysm and distal bypass, which was described for the treatment of a left main coronary artery aneurysm. 7) However, the disadvantage of this strategy is that PCI cannot be performed when revascularization is necessary for a new lesion of the left coronary artery system in the future.…”