Successful Surgical Treatment of Giant Coronary Artery Aneurysm and Concomitant Coronary Artery Fistula to the Pulmonary Artery

  • Keito Suzuki Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Naoyuki Kimura Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Akira Sezai Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Satoshi Unosawa Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Makoto Taoka Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Shunji Osaka Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
  • Masashi Tanaka Department of Cardiovascular Surgery, Nihon University School of Medicine, Tokyo, Japan.
Keywords: giant coronary artery aneurysm, coronary-to-pulmonary fistula, coronary artery bypass grafting

Abstract

Giant coronary artery aneurysm (GCAA) combined with coronary artery fistula to the pulmonary artery (PA) is rare. A 79-year-old man was accidentally discovered with GCAA. He was operated on by use of aneurysmorrhaphy, and closure of the fistulae was performed. Because ischemic changes appeared, coronary artery bypass grafting was done. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. We report here a case of GCAA with a size of 66 × 52 mm in diameter associated with a fistula formation into the PA. It is one of the largest sizes of GCAA that has occurred after fistula formation.

References

Abou Sherif S, Ozden Tok O, Taskoylu O, Goktekin O, Kilic ID. 2017. Coronary artery aneurysms: a review of the epidemiology, pathophysiology, diagnosis, and treatment. Front Cardiovasc Med 4:24.

Barr J, Acharya MN, Kourliouros A, Raja SG. 2016. Technical Considerations of Giant Right Coronary Artery Aneurysm Exclusion. Case Rep Surg 2016:3795640.

Cao H, Ye L, Chan P, Fan H, Liu Z. 2015. Giant coronary artery aneurysm with fistula to the pulmonary artery complicated by frequent ventricular premature contractions: a case report. Medicine (Baltimore) 94:e530.

Chiang JY, Wu CK, Luo JL, Yu HY. 2014. A giant left main coronary artery aneurysm with fistula to the pulmonary artery, manifested with ST-segment elevation myocardial infarction. JACC Cardiovasc Interv 7:e55-6.

Crawley PD, Mahlow WJ, Huntsinger DR, Afiniwala S, Wortham DC. 2014. Giant coronary artery aneurysms: review and update. Tex Heart Inst J 41:603-8.

Hirose H, Amano A, Yoshida S, et al. 1999. Coronary artery aneurysm associated with fistula in adults: collective review and a case report. Ann Thorac Cardiovasc Surg 5:258-64.

Li D, Wu Q, Sun L, et al. 2005. Surgical treatment of giant coronary artery aneurysm. J Thorac Cardiovasc Surg 130:817-21.

Morita H, Ozawa H, Yamazaki S, et al. 2012. A case of giant coronary artery aneurysm with fistulous connection to the pulmonary artery: a case report and review of the literature. Intern Med 51:1361-6.

Tokunaga C, Imai A, Enomoto Y, et al. 2010. Giant coronary artery aneurysm with pulmonary artery fistula in a patient on chronic hemodialysis. Ann Thorac Surg 89:963-5.

Zhaoping C, Ximing W, Bin Z, Yanhua D, Juan F, Mei Z. 2015. Giant coronary aneurysm secondary to coronary-atrial fistula. J Am Coll Cardiol 65:e3.

Published
2018-06-14
Section
Articles