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• W2348626521 abstract "Summary Coronary artery aneurysm is a rare disease diagnosed in 0.3 to 4.9% of patients undergoing coronary angiography. The incidence of left main coronary artery aneurysm (LMCAA) is extremely rare: 0.1% [1]. Coronary artery aneurysm involves the right coronary artery, the left anterior descending and circumflex coronary arteries in descending order of frequency [2] and atherosclerosis is the most common cause. Other causes include arteritis, Kawasaki disease, angioplasty sequelae, laser procedures, traumatic injury, dissection, connective tissue disorders, Takayasu’s arteritis, congenital (anomaly or genetic disorders such as Ehler-Danlos syndrome, Marfan syndrome) mycotic and idiopathic diseases. Although surgery has been recommended to prevent complication, there are no large available data comparing medical and surgical therapy [3-5]. The LMCAA is a rare clinical entities, encountered incidentally in approximately 0.1% of patients undergone routine angiography [6,7]. The sizes of LMCAAs may be fusiform or saccular. Management of these cases is still controversial, based on anedoctal experience rather than controlled trials. We present a case of a 68 year old man referred to our Institution because of ingravescent dyspnea and orthopnea. The angiographic study showed a left main large aneurism involving the ostia of the left anterior descending artery and circumflex artery. The patient was referred to Cardio chirurgic Center for by-pass surgery intervention. Case Report A 68 year old man was referred to our Hospital because of worsening dyspnea and orthopnea. He had a past medical history of hypertension, dislipidemia and polivasculophaty. Laboratory data were normal. Physical examination showed bilateral pulmonary crackles. Electrocardiogram was normal without Q waves or ST-T segment changes. The patient was treated with conservative therapy: diuretics and inotropic agents ev. The situation evolved better rapidly. Four days later a coronary angiography was performed and showed a large ectasia of the medium tract and a very large aneurysm (11.2 x 8.5 mm) originating at the distal segment of the left main coronary artery. The true aneurysm involved the ostia of the left anterior descending, the ramus intermedius and circumflex coronary artery (Figure 1 and Figure 2). The right coronary artery was dominant and ectasic, without significant stenoses. The left ventricular ejection fraction was normal with no wall motion abnormalities. The patient was transferred in a Cardiochirurgic Center to perform by-pass surgery." @default.
• W2348626521 created "2016-06-24" @default.
• W2348626521 creator A5082964368 @default.
• W2348626521 date "2016-03-07" @default.
• W2348626521 modified "2023-09-27" @default.
• W2348626521 title "Atherosclerotic Monstrous Double Aneurysm of the Left Main Coronary Artery: A Very Rare Angiographic Finding" @default.
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• W2348626521 doi "https://doi.org/10.17352/2455-2976.000022" @default.
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