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Case Reports
. 2021 Oct;49(10):3000605211053228.
doi: 10.1177/03000605211053228.

Surgical repair of a coronary artery aneurysm associated with coronary artery fistula - a case report

Rudolf Špunda  1 , Jan Horák  2 , Pavol Tomašov  2 , Lukáš Lambert  3 , Miroslav Špaček  1 , Andrey Slautin  1 , Tomáš Prskavec  1 , Jaroslav Lindner  1
Affiliations
Case Reports

Surgical repair of a coronary artery aneurysm associated with coronary artery fistula - a case report

Rudolf Špunda et al. J Int Med Res. 2021 Oct.

Abstract

Coronary artery aneurysm is a relatively rare disorder that is usually discovered as a secondary finding in patients undergoing coronary artery angiography. Coronary artery fistulas are relatively more frequent than rare aneurysms and are often associated with other cardiac abnormalities. The etiology of aneurysms is mostly atherosclerotic, and they are less frequently associated with other acquired or congenital diseases, such as Kawasaki disease, connective tissue diseases, septic emboli, arteritis, and iatrogenic disease. We report a 70-year-old woman with a rare combination of a coronary artery aneurysm associated with a coronary artery fistula, which drained into the pulmonary artery. The diagnosis of our patient was made by selective coronary angiography and confirmed by computed tomography angiography. The patient was treated surgically because of the symptomatic course of the disease.

Keywords: Coronary artery aneurysm; chest pain; computed tomography angiography; fistula; pulmonary artery; thrombus.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
Left coronary angiography shows two aneurysms. The cranial and smaller aneurysm is supplied by vessels that originate from the left and right coronary arteries.
Figure 2.
Figure 2.
Right coronary angiography shows an aberrant vessel, which terminates in the smaller aneurysm, and this is connected to the pulmonary artery.
Figure 3.
Figure 3.
Three-dimensional reconstruction of computed tomography coronary angiography shows the position of both aneurysms and their supplying arteries.
Figure 4.
Figure 4.
Perioperative photograph of removal of an adhering thrombus on a coronary artery aneurysm.
Figure 5.
Figure 5.
Perioperative photograph showing the opened aneurysms and fistula to the pulmonary artery (smaller aneurysm 2).
See this image and copyright information in PMC

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