Overview: This article reviewed the case of a patient with giant coronary aneurysm (dilatation of the coronary artery exceeding 50% of the reference vessel diameter) complicated by acute myocardial infarction (heart attack) and cardiopulmonary (heart and lung) arrest.
Conclusion: After cardiopulmonary (heart and lung) resuscitation and cardiopulmonary support, emergent excision of aneurysm (abnormal bulge or ballooning in the wall of a blood vessel) and coronary artery bypass grafting (operation that improves blood flow to the heart) was performed. The postoperative (after surgery) course was good without complications.
Giant coronary aneurysm is rare, but a life-threatening disease. We report a 67-year-old man with 39 mm coronary aneurysm. He was presented to our facility with acute coronary syndrome complicated by cardiogenic shock. Angiography demonstrated giant coronary aneurysm and occlusion of the right coronary artery. After cardiopulmonary resuscitation and cardiopulmonary support (PCPS), emergent excision of aneurysm and coronary artery bypass grafting was performed. The postoperative course was good without complications. Most giant coronary artery aneurysms are asymptomatic but some patients present with angina pectoris, sudden death, fistula formation, pericardial tamponade, compression of surrounding structures, or congestive heart failure. But once complications, such as thrombosis, distal embolization, fistula formation or rupture occurred, it is difficult to save life without aggressive surgery. At present, there are no specific guidelines for the treatment of giant coronary aneurysm. Surgical correction is a preferred approach for the treatment of giant coronary artery aneurysms.