Surgical treatment of giant coronary artery aneurysm

Li, Dianyuan; Wu, Qingyu; Sun, Lixian; Song, Yunhu; Wang, Wei; Pan, Shiwei; Li, Guohua; Liu, Yongmin; Qi, Zhitao; Tao, Tian-fu; Sun, Jianyong; Hu, Shengshou

doi:10.1016/j.jtcvs.2005.04.004

Cited by 168 publications

(126 citation statements)

References 9 publications

(13 reference statements)

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“…Doppler echocardiography remains of great diagnostic value in the detection, intra-operative imaging and follow-up of patients with CAFs [2,22] . CAFs could be suspected [7,8] and confirmed [51,65,66] by echocardiography, as well as demonstration of dilatation and aneurysm of the donor vessel [34,36,[67][68][69][70] and dilatation of the recipient chamber [3,4,[71][72][73] . Thrombotic or vascular masses have been visualized by echocardiography [72] .…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

“…The clinical presentations consisted of dyspnea [111,112] , palpitations [69,81] , syncope [83] , angina pectoris [113,114] , chest pain [84] , fatigue [66,115] , CHF [45] and IE [39,40,43] . The termination of RCA fistulas was variable: RA 26%, RV 25%, PA 16%, CS 11%, left LV 12%, LA 3%, SVC 5%, RVOT 1% and PV 1% [33,41,72,70,110,116] . The clinical presentations were angina pectoris [27,35,79] , chest pain [9,31,51,117] , dyspnea [36,68] , palpitations [33] and syncope [118] .…”

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

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Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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AIM:To describe the characteristics of coronary artery fistulas (CAFs) in adults, including donor vessels and whether termination was cameral or vascular. METHODS:A PubMed search was performed for articles between 2000 and 2010 to describe the current characteristics of congenital CAFs in adults. A group of 304 adults was collected. Clinical data, presentations, diagnostic modalities, angiographic fistula findings and treatment strategies were gathered and analyzed. With regard to CAF origin, the subjects were tabulated into unilateral, bilateral or multilateral fistulas and compared. The group was stratified into two major subsets according to the mode of termination; coronary-cameral fistulas (CCFs) and coronary-vascular fistulas (CVFs). A comparison was made between the two subsets. Fistula-related major complications [aneurysm formation, infective endocarditis (IE), myocardial infarction (MI), rupture, pericardial effusion (PE) and tamponade] were described. Coronary artery-ventricular multiple micro-fistulas and acquired CAFs were excluded as well as anomalous origin of the coronary arteries from the pulmonary artery (PA). RESULTS:A total of 304 adult subjects (47% male) with congenital CAFs were included. The mean age was 51.4 years (range, 18-86 years), with 20% older than 65 years of age. Dyspnea (31%), chest pain (23%) and angina pectoris (21%) were the prevalent clinical presentations. Continuous cardiac murmur was heard in 82% of the subjects. Of the applied diagnostic modalities, chest X-ray showed an abnormal shadow in 4% of the subjects. The cornerstone in establishing the diagnosis was echocardiography (68%), and conventional contrast coronary angiography (97%). However, multislice detector computed tomography was performed in 16%. The unilateral fistula originated from the left in 69% and from the right coronary artery in 31% of the subjects. Most patients (80%) had unilateral fistulas, 18% presented with bilateral fistulas and 2% with multilateral fistulas. Termination into the PA was reported in unilateral (44%), bilateral (73%) and multilateral (75%) fistulas. Fistulas with multiple origins (bilateral and multilateral) terminated more frequently into the PA (29%) than into other sites (10.6%) (P = 0.000). Aneurysmal formation was found in 14% of all subjects. Spontaneous rupture, PE and tamponade were reported in 2% of all subjects. In CCFs, the mean age was 46.2 years whereas in CVFs mean age was 55.6 years (P = 0.003). IE (4%) was exclusively associated with CCFs, while MI (2%) was only found in subjects with CVFs. Surgical ligation was frequently chosen for unilateral (57%), bilateral (51%) and multilateral fistulas (66%), but percutaneous therapeutic embolization (PTE) was increasingly reported (23%, 17% and 17%, respectively). CONCLUSION:Congenital CAFs are currently detected in elderly patients. Bilateral fistulas are more frequently reported and PTE is more frequently applied as a therapeutic strategy in adults.

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Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

Section: Abnormal Shadow On Chest X-raymentioning

confidence: 99%

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Saïd

2011

WJC

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“…With proximal lesions, resection and coronary artery bypass grafting (CABG) appears to be the most frequently chosen strategy. Where the coronary artery is diffusely ectatic, thrombectomy and CABG without coronary resection has been performed with good effect [5]. Covered stents with long term anticoagulant and antiplatelet therapy have also been described [6].…”

Section: Discussionmentioning

confidence: 99%

A Giant Thrombosed Right Coronary Artery Aneurysm Presenting as an Obstructing Left Atrial Mass.

Eynaud

Manche

2018

ICFJ

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“…4 Surgical techniques vary but involve aneurysm resection, ligation, or marsupilization followed by the interposition of graft vessels. 12,13 In regard to our patient, tourniquets were placed in the proximal aspect of the aneurysmal vessels to stop the blood flow followed by graft anastomosis. Patients with higher perioperative risk may be managed with a percutaneous approach.…”

Section: Discussionmentioning

confidence: 99%

Urgent Coronary Artery Bypass Grafting Due to Multi- Vessel Coronary Aneurysm

Aqtash¹,

Amro²,

Alam³

et al. 2018

MJM

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1. Cohen P, O'Gara PT. Coronary artery aneurysms: a review of the natural history, pathophysiology, and management. Cardiol Rev. 2008;16(6) 1. Marshall University, Huntington, West Virginia 2. An-najah National University, Nablus, West Bank, Palestine:The authors have no financial disclosures to declare and no conflicts of interest to report. AbstractCoronary artery aneurysm (CAA) is defined as a dilation of more than 1.5 times normal in a segment of the coronary artery. The incidence of CAA is highest in the right coronary artery (RCA); left main coronary artery or three-vessel involvement is extremely rare. Wide ranges of factors have been implicated in the cause of CAA; atherosclerosis is the most common at 50%. Congenital CAA occurs in 20-30% of cases followed by connective tissue disease at 10%. Blood stagnation and exposure of the underlying collagen make aneurysms prone to thrombosis, dissection, and vasospasm. Depending on the size, symptoms, and etiology of the aneurysms, a surgical, percutaneous, or medical approach may be used. In this paper, we present a patient who presented to the emergency department (ED) with chest pain due to acute coronary syndrome (ACS) that was found to be due to multi-vessel CAAs. The left main as well as RCA, left anterior descending (LAD) artery and left circumflex artery (LCA) were involved and urgent coronary artery bypass grafting (CABG) was required.

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Surgical treatment of giant coronary artery aneurysm

Abstract: Giant coronary artery aneurysm is a rare entity that is commonly caused by congenital malformation and combined with other cardiac anomalies. An optimal surgical operation should be based on the specific cardiac anomaly of the individual patient.

Cited by 168 publications

References 9 publications

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

Current characteristics of congenital coronary artery fistulas in adults: A decade of global experience

A Giant Thrombosed Right Coronary Artery Aneurysm Presenting as an Obstructing Left Atrial Mass.

Urgent Coronary Artery Bypass Grafting Due to Multi- Vessel Coronary Aneurysm

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