Surgical Treatment of Coronary Pseudoaneurysm: A Case Report and Literature Review

Authors

  • Haiyan Xiang Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Rifeng Gao Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Juesheng Yan Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Juxiang Li Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Jin Li Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Fei Lu Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China
  • Yanhua Tang Department of Cardiovascular Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi Province, China

DOI:

https://doi.org/10.1532/hsf.2651

Keywords:

mediastinal occupying lesion, coronary artery pseudoaneurysm, surgical procedure, coronary angiography

Abstract

A coronary pseudoaneurysm is a rare complication of chest trauma. In this report, we describe the case of a 65-year-old man with a mediastinal lesion. On admission, he complained of chest tightness and dry cough, and a pseudoaneurysm was confirmed in the left anterior descending branch of the coronary artery on chest computerized tomography, angiography, and coronary angiography. The patient had experienced chest trauma 5 years previously. With the help of extracorporeal bypass surgery, the pseudoaneurysm was resected under direct observation. The patient recovered well after surgery. Traumatic coronary artery pseudoaneurysms usually are asymptomatic and often misdiagnosed. Preoperative coronary angiography is a crucial diagnostic used for deciding appropriate surgical management.

References

Alston EA, Brott BC, Misra VK, Athanasuleas CL, Anderson PG, Litovsky SH. 2013. Histologic analysis of a covered stent implanted for pseudoaneurysm in a coronary artery. Cardiovasc Pathol 22(3):e19-21.

Aqel RA, Zoghbi GJ, Iskandrian A. 2004. Spontaneous coronary artery dissection, aneurysms, and pseudoaneurysms: a review. Echocardiography 2:75-82.

Copeland K, Hopkins J, Weintraub W, Rahman W. 2012. Long-term follow-up of polytetrafluoroethylene-covered stents implanted during percutaneous coronary intervention for management of acute coronary perforation. Catheter Cardiovasc Interv 80:53-7.

Hagau AM, Dudea SM, Hagau R, Hagau N. 2013. Large coronary pseudoaneurysm with pulmonary artery fistula, six months after left main trunk stenting with paclitaxel-eluting stent. Med Ultrason 15(1):59-62.

Hobelmann A, Pham JC, Hsu EB. 2006. Case of the month: right coronary artery dissection following sports related blunt trauma. Emerg Med J 23:580-1.

Iemura J, Oku H, Shirotani H. 1996. Right coronary artery pseudoaneurysm after blunt injury to the chest. Heart 76-86.

lga K, Fuikawa T, Ueda Y, et a1. 1996. Massive hemopericardium as a first manifestation of coronary aneurysm: successful surgical management. Am Heart J 131:618-620.

Kawazoe H, Ikeda S, Uga S, Yamane KI, Ohshima K, Hamada M. 2013. Spontaneous disappearance of coronary pseudoaneurysm due to coronary artery perforation following percutaneous coronary intervention. Cardiovasc Interv Ther 28(4):408-414.

Lansky AJ, Yang Y, Khan Y, et al. 2006. Treatment of coronary artery perforations complicating percutaneous coronary intervention with a polytetrafluoroethylene covered stent graft. Am J Cardiol 98:370-374.

Ly H, Awaida J-P, Lesperance J, Bilodeau L. 2005. Angiographic and clinical outcomes of polytetrafluoroethylene-covered stent use in significant coronary perforations. Am J Cardiol 95:244–6.

Miwa K, Matsubara T, Yasuda T, et al. 2012. Spontaneous healing of posttraumatic focal coronary aneurysm: a case report. Heart Lung 41(6):613-6.

Rao RK, Yadav SR, Roy VN. 2008. Coronary pseudoaneurysm: an uncommon cause of P.U.O. after a common procedure: an interesting case report. Int J Cardiol 127(1): e18-21.

Romaguera R, Waksman R. 2011. Covered stents for coronary perforations: is there enough evidence? Catheter Cardiovasc Interv 78:246-253.

RuDusky BM. 2007. Classification of myocardial contusion and blunt cardiac trauma. Angiology 58:610-613.

Sasaguri S, Nishimori H, Wariishi, S. 2011. A surgical case report of off-pump onlay patch grafting for pseudoaneurysm with diffusely calcified coronary artery. Ann Thorac Cardiovasc Surg 17:94–96.

Shimony A, Joseph L, Mottillo S, Eisenberg MJ. 2011. Coronary artery perforation during percutaneous coronary intervention: a systematic review and meta-analysis. Can J Cardiol 27:843-50.

Yoshioka D, Izutani H, Ryugo M, Kawachi K, Sawa Y. 2011. Asymptomatic giant traumatic right coronary artery pseudoaneurysm caused by sternal fracture. Ann Thorac Surg 92:33-35.

Published

2020-05-06

How to Cite

Xiang, H., Gao, R., Yan, J., Li, J., Li, J., Lu, F., & Tang, Y. (2020). Surgical Treatment of Coronary Pseudoaneurysm: A Case Report and Literature Review . The Heart Surgery Forum, 23(3), E287-E291. https://doi.org/10.1532/hsf.2651

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