Can we medically follow coronary artery aneurysms?; A case report
Abstract
Coronary artery aneurysm (CAA) is an enlargement of the coronary vascular lumen that can’t be fixed and is at least 1.5 times the diameter of the normal coronary segment next to or connected to it. They are usually asymptomatic; their clinical presentation ranges from incidental findings on cardiac imaging to myocardial infarction (MI), and they may result in angina, MI, and sudden death, especially when they are very large. An aneurysm was seen in the middle segment of the left anterior descending artery (LAD) in the images obtained from the patient. After the council, coronary artery bypass grafting (CABG) was decided due to the risk of rupture, but the patient and his relatives did not accept the operation. In outpatient clinic visits every 3 months for 9 months, it was observed that her complaints regressed with medical treatment. There is still no clear treatment approach for CAAs and CABG, and percutaneous coronary intervention (PCI) may be preferred or medical therapy may be used.
Keywords
coronary artery aneurysm , Aneurysmal coronary artery disease , left anterior descending artery
Kaynakça
- El Guindy MS, El Guindy AM. Aneurysmal coronary artery disease: an overview. Glob Cardiol Sci Pract 2017; e201726.
- Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134-8.
- Takahashi K, Oharaseki T, Naoe S, Wakayama M, Yokouchi Y. Neutrophilic involvement in the damage to coronary arteries in acute stage of Kawasaki disease. Pediatr. Int. 2005;47:305-10
- Collins MJ, Borges AJ, Singh G, Pillai JB, David TE, Leong SW, et al. A giant coronary artery aneurysm in the right coronary artery. Cardiovasc Pathol 2006;15(3):150–2
- Kawsara A, Núñez Gil IJ, Alqahtani F, Moreland J, Rihal CS, Alkhouli M. Management of Coronary Artery Aneurysms. JACC Cardiovasc Interv. 2018;11(13):1211-1223.
- Chrissoheris MP, Donohue TJ, Young RS, Ghantous A. Coronary artery aneurysms. Cardiol Rev. 2008;16(3):116-23.
- Morita H, Ozawa H, Yamazaki S, Yamauchi Y, Tsuji M, Katsumata T, et al. A case of giant coronary artery aneurysm with fistulous connection to the pulmonary artery: a case report and review of the literature. Intern Med. 2012;51(11):1361-6.
- Núñez-Gil IJ, Terol B, Feltes G, Nombela-Franco L, Salinas P, Escaned J, et al. Coronary aneurysms in the acute patient: Incidence, characterization and long-term management results. Cardiovasc Revasc Med. 2018;19(5 Pt B):589-596.
- Ipek G, Gungor B, Karatas MB, Onuk T, Keskin M, Tanik O, et al. Risk factors and outcomes in patients with ectatic infarct-related artery who underwent primary percutaneous coronary intervention after ST elevated myocardial infarction. Catheter Cardiovasc Interv. 2016;88(5):748-753.
- Iannopollo G, Ferlini M, Koziński M, Ormezzano MF, Crimi G, Lanfranchi L, et al. Patient outcomes with STEMI caused by aneurysmal coronary artery disease and treated with primary PCI. J Am Coll Cardiol. 2017;69(24):3006-3007.