Iwakura T, Toguchi K, Kato I, Asakawa N. Internal thoracic artery patch repair of a saccular left main coronary artery aneurysm.
J Cardiothorac Surg 2019;
14:38. [PMID:
30808396 PMCID:
PMC6390321 DOI:
10.1186/s13019-019-0868-0]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/17/2019] [Indexed: 11/21/2022] Open
Abstract
Background
A saccular aneurysm located at the bifurcation of the left main coronary artery (LMCA) is an extremely rare condition. A major cause of left main coronary aneurysm is atherosclerosis, and common complications include thrombosis, embolism, and rupture. Despite the serious nature of this condition, the ideal operative approach to LMCA aneurysm (LMCAA) has not been established. Furthermore, little is known about resection of the saccular aneurysm and closure using a small internal thoracic artery patch.
Case presentation
Here, we present the case of a 66-year-old woman who had significant stenosis in the left anterior descending artery and a saccular aneurysm at the bifurcation of the LMCAA, which was repaired using a small internal thoracic artery patch during coronary artery bypass grafting. Postoperative multislice computed tomography revealed the complete disappearance of the aneurysm and a successful repair with no luminal stenosis of the internal thoracic artery patch. In addition, the left internal thoracic artery graft was found to be patent.
Conclusions
Resection of the saccular LMCA aneurysm and closure using a small internal thoracic artery patch is safe and offer excellent results.
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