Incidental Diagnosis of a Giant Coronary Artery Pseudoaneurysm

Atsushi Hiromoto and Jiro Honda

（Department of Cardiovascular Surgery, Nakagami Hospital, Okinawa, Japan, and Present address:Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan）

Coronary artery pseudoaneurysms are rare, and usually present as long-term complications of percutaneous coronary intervention or coronary artery bypass grafting, or as a side effect of systemic vasculitis, including Beh●et disease. A 60-year-old man was admitted to our hospital due to a hemorrhagic duodenal ulcer. As a mucosal bulge at the fornix was detected on upper gastrointestinal endoscopy, the patient underwent a further examination of other organs using computed tomography. Coronary computed tomography and coronary angiography revealed a right coronary artery aneurysm with a maximum diameter of 43mm and 90% stenosis in the left anterior descending artery. The patient successfully underwent coronary artery aneurysmectomy and coronary artery bypass grafting of the left anterior descending artery using the left mammary artery. The pathological findings were consistent with those of a pseudoaneurysm. In the present case, the coronary pseudoaneurysm may have been due to traumatic because he had experienced neither coronary treatments nor systemic vasculitis, although he had suffered blunt trauma that involved splenectomy 30 years earlier.

 

Jpn. J. Cardiovasc. Surg. 43:191-194（2014）

Keywords：coronary artery aneurysm;blunt trauma;pseudoaneurysm