Key result
Resection and bypass of giant coronary artery aneurysms yields asymptomatic survival at 2 years.
Why the study?
Management of giant coronary aneurysms is unclear due to their rarity and limited data on treatment outcomes.
Case Report (n=1)
No
This case highlights surgery as a viable treatment option for giant coronary aneurysms, which may have poor outcomes with conservative management.
BACKGROUND: Coronary artery aneurysms (CAA) are defined as localized coronary artery dilations more than 1.5 times the diameter of the adjacent segments [1]. Giant coronary aneurysms (GCAA) are unusual and aneurysms on the left side are even rarer. Mechanisms are unclear, but seem predominated by atherosclerosis. Until now, management of giant coronary aneurysm is still unclear. CASE PRESENTATION: A 62-year-old man, presented a 4-month history of progressive chest pain aggravated by physical CAAs: 3 on the right coronary artery (RCA), including a giant one, and one on the intermediate branch. Intraoperatively, we found two proximal RCA CAAs of 2 cm each, a 6 cm distal RCA CAA partially thrombosed, and a 3 cm CAA on the intermediate branch. The two largest CAAs were resected and two saphenous graft bypasses were performed. CONCLUSIONS: Treatment options include medical treatment (antiaggregation, anticoagulation), percutaneous coronary angioplasty and surgery. Results of observational or conservative management in the few cases of GCAA described in literature, appear to have poor results. Surgery is a good option with low operative risk, especially in giant coronary aneurysms.
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Pfister et al. (2019) conducted a case report in Giant coronary aneurysms (n=1). Surgical resection and coronary bypass was evaluated on Clinical outcome at 2 years.
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