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Case Reports
. 2020 Jan 13;15(1):17.
doi: 10.1186/s13019-020-1054-0.

Giant right coronary artery aneurysm mimicking a right intra-ventricular mass: a case report

Peng Teng  1 , Chengyao Ni  1 , Qianhui Sun  2 , Yiming Ni  3
Affiliations
Case Reports

Giant right coronary artery aneurysm mimicking a right intra-ventricular mass: a case report

Peng Teng et al. J Cardiothorac Surg. .

Abstract

Background: Coronary artery aneurysm is a rare condition which constitutes a small proportion of coronary artery disease. Such condition mimicking an intra-cardiac mass is extremely rare and poorly understood.

Case presentation: We present an unusual case of a 53-year-old female with decreased exercise tolerance and lower extremity edema for 3 months. The echocardiography showed moderate tricuspid regurgitation and a right intra-ventricular mass below the tricuspid valve. No ventricular wall akinesia or ST segment change was found on echocardiography or electrocardiogram. Coronary computed tomographic angiography confirmed the diagnosis of intra-ventricular mass with feeding vessel originated from the right coronary artery. The patient was scheduled for tumor resection, and the mass turned out to be a thrombosed giant right coronary artery aneurysm. The patient received successful aneurysm resection and had an uneventful postoperative recovery. Unfortunately, a fistula between right coronary artery and right ventricle was detected on follow-up three months later by echocardiography.

Conclusions: Coronary artery aneurysms presenting as intra-cardiac masses are extremely rare. Comprehensive preoperative evaluation is highly recommended because the surgical strategies for tumor and aneurysm are completely different. Aneurysm resection with bypass surgery is preferred rather than aneurysm repair. To our best knowledge, coronary artery aneurysms presenting as intra-ventricular masses have seldom been reported.

Keywords: Cardiac mass; Coronary artery aneurysm; Right coronary artery; Right ventricle.

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Conflict of interest statement

None declare.

Figures

Fig. 1
Fig. 1
(A) TEE revealed a 3.5 × 2.7 cm cystic mass (white arrows) with hyperechoic external capsule locating below the annulus of posterior tricuspid leaflet; (B, C) Coronary CTA revealed an irregular mass (white arrows) with internal contrast enhancement and thick external capsule locating below the tricuspid valve. A feeding vessel (black arrow) originating from RCA (white arrow head) was identified; (D) 3D reconstruction of coronary arteries confirmed that the mass was supplied by RCA and left coronary artery disease was eliminated; (E) After detaching the posterior leaflet from the tricuspid annulus, the mass (white arrows) was detected with collagen-like degenerative fibrous coating; (F) The RCA aneurysm was resected and the posterior leaflet was repaired and reattached to the annulus by continuous suture with 5–0 prolene. TEE, transthoracic echocardiography; CTA, computed tomographic angiography; RCA, right coronary artery
See this image and copyright information in PMC

Comment in

References

    1. Gottesfeld S, Makaryus AN, Singh B, Kaplan B, Stephen B, Steinberg B, et al. Thrombosed right coronary artery aneurysm presenting as a myocardial mass. J Am Soc Echocardiogr. 2004;17(12):1319–1322. doi: 10.1016/j.echo.2004.07.004. - DOI - PubMed
    1. Pereira E, Melica B, Primo J, Mota JC, Ferreira N, PM G, et al. Diffuse aneurysmal and obstructive coronary artery disease: a do-not-intervene patient. Rev Port Cardiol. 2013;32(7–8):629–632. doi: 10.1016/j.repc.2012.11.009. - DOI - PubMed
    1. Syed M, Lesch M. Coronary artery aneurysm: a review. Prog Cardiovasc Dis. 1997;40(1):77–84. doi: 10.1016/S0033-0620(97)80024-2. - DOI - PubMed
    1. Swaye PS, Fisher LD, Litwin P, Vignola PA, Judkins MP, Kemp HG, et al. Aneurysmal coronary artery disease. Circulation. 1983;67(1):134–138. doi: 10.1161/01.CIR.67.1.134. - DOI - PubMed
    1. Ebina T, Ishikawa Y, Uchida K, Suzuki S, Imoto K, Okuda J, et al. A case of giant coronary artery aneurysm and literature review. J Cardiol. 2009;53(2):293–300. doi: 10.1016/j.jjcc.2008.07.015. - DOI - PubMed

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