Ruptured Coronary Artery Aneurysm with a Fistulous Communication

(Department of Cardiovascular Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan)

Akira Yamazaki Touitsu Hirayama Hiroyasu Misumi
Yasuhiro Shimokawa Hideyuki Uesugi Ichiro Ideta
Masamitsu Murata
A 68-year-old woman was referred to our hospital with arrhythmia and cardiomegaly. She lost consciousness in the waiting room. After urgent hospitalization, cardiac ultrasonography showed cardiac tamponade, and urgent pericardial drainage was performed. A ruptured coronary aneurysm with a fistulous communication was diagnosed by CT scan and coronary angiography. Under extracorporeal circulation, ligation of the unusual coronary vessels and resection of the aneurysm were performed. The postoperative course was uneventful and she was discharged on the 25th postoperative day. No ischemic signs were observed on treadmill test at one year after surgery. Most congenital coronary aneurysms are asymptomatic; however, once rupture occurs, it is important to diagnose this condition rapidly and treat surgically.
@Jpn. J. Cardiovasc. Surg. 35: 351-353 (2006)