Author + information
- Received October 17, 2007
- Accepted October 24, 2007
- Published online January 27, 2009.
- Ravinay Bhindi, MBBS, PhD, FRACP, FESC,
- Luca Testa, MD,
- Oliver J. Ormerod, DM, FRCP and
- Adrian P. Banning, MD, FRCP, FESC
Coronary artery aneurysms are relatively uncommon (1,2), and their treatment remains uncertain. This case illustrates dramatic progressive dilatation of a left anterior descending artery (LAD) aneurysm, treated with a covered stent. A 63-year-old male with a background history remarkable for hypertension and previous smoking presented 18 months prior to the current presentation for elective coronary angiography for chest pain (A). This revealed an ectatic proximal LAD (arrow) with no significant flow-limiting lesions. Twelve months later, angina developed, and repeat angiography demonstrated a moderate to severe stenosis of the proximal LAD (dotted arrow) followed by significant aneurysmal dilation (arrow) of the LAD. There was moderate ostial circumflex disease (B). The patient was referred for coronary artery bypass graft surgery and received a left internal mammary artery graft to the LAD and a vein graft to the obtuse marginal circumflex. Six months later, the patient presented with further angina, and angiography (C) revealed further dilation (15 × 9 mm) of the LAD aneurysm (arrow) and occlusion of the left internal mammary graft. Given the rapidly progressive nature of the aneurysm, a single covered stent (D, dotted arrow) was placed over the mouth of the aneurysm, to obstruct blood flow into the sac and potentially reduce the risk of catastrophic rupture.
- Received October 17, 2007.
- Accepted October 24, 2007.
- American College of Cardiology Foundation
- Swaye P.S.,
- Fisher L.D.,
- Litwin P.,
- et al.