•  
  •  
 

Abstract

Abstract

Background: A “giant” coronary artery aneurysm is variably defined in the literature—commonly as a dilatation of a coronary vessel exceeding four times the diameter of the adjacent normal segment, or exceeding a fixed threshold such as > 8 mm or > 20 mm in diameter1.

Case presentation: We report the case of a 61-year-old woman with type II diabetes mellitus and systemic hypertension, who presented with breathlessness and chest pain radiating to the back. She had recently suffered a non-ST elevation myocardial infarction (NSTEMI) and was found on coronary angiography to have a large aneurysm of the acute marginal branch of the right coronary artery (RCA). Given the extreme size of 6x 4cm and branch-vessel location, this meets the criteria for a giant aneurysm. She underwent successful surgical repair under cardiopulmonary bypass—without aortic cross-clamping or bypass grafting. Histopathologic examination excluded infection and vasculitis. Her postoperative course was uneventful, and she was discharged on postoperative day four.

Conclusion: Isolated Giant acute marginal artery aneurysm causing life threatening symptoms are exceptionally rare; this report highlights the importance of branch vessel aneurysm and feasibility of successful direct surgical repair with preservation of native coronary perfusion.

Keywords

Coronary artery aneurysm; Giant; NSTEMI; Acute marginal artery; Right coronary artery

Share

COinS