Giant coronary artery aneurysm(CAA)is a rare condition,reportedly seen in 0.02-0.2%of patients undergoing coronary angiography.Asymptomatic in most cases,patients may present with angina pectoris,myocardial infarction...Giant coronary artery aneurysm(CAA)is a rare condition,reportedly seen in 0.02-0.2%of patients undergoing coronary angiography.Asymptomatic in most cases,patients may present with angina pectoris,myocardial infarction,cardiac tamponade or sudden death.Given that the natural history of the CAA is still not predictable,the optimal treatment remains still debatable.In this case report,we present a male patient with a sudden non-exertional dyspnea and angina in a context of obesity,multiple large and medium vessels aneurysms and chronic kidney disease(CKD).A contrast CT detected a giant left anterior descending artery(LAD)CAA measuring 73 mm×47 mm,apparently compressing the circumflex(CX)and the pulmonary artery(PA).After undergoing a full(etiologic and aneurysm extension)panel of exams,the patient underwent a surgical exclusion of the giant CAA and a coronary artery bypass grafting(CABG)by using the left thoracic mammary artery(LITA).The hospitalization was uneventful,and the patient left the hospital completely asymptomatic.In conclusion,even in cases of giant coronary aneurysms,the treatment is surgical by excluding the aneurismatic sac and performing a surgical revascularization.展开更多
Kawasaki disease(KD)is an acute systemic vasculitis characterized by unknown etiology.CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD.He still had persistent abdominal pain...Kawasaki disease(KD)is an acute systemic vasculitis characterized by unknown etiology.CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD.He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy.Ultrasound examination at early onset revealed a giant coronary artery aneurysm.The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest.He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery.After the operation,the cardiac output increased,and the symptoms of heart failure resolved.Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure,and normal growth was obtained.CONCLUSION Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm.Nevertheless,some issues still need specific attention.展开更多
文摘Giant coronary artery aneurysm(CAA)is a rare condition,reportedly seen in 0.02-0.2%of patients undergoing coronary angiography.Asymptomatic in most cases,patients may present with angina pectoris,myocardial infarction,cardiac tamponade or sudden death.Given that the natural history of the CAA is still not predictable,the optimal treatment remains still debatable.In this case report,we present a male patient with a sudden non-exertional dyspnea and angina in a context of obesity,multiple large and medium vessels aneurysms and chronic kidney disease(CKD).A contrast CT detected a giant left anterior descending artery(LAD)CAA measuring 73 mm×47 mm,apparently compressing the circumflex(CX)and the pulmonary artery(PA).After undergoing a full(etiologic and aneurysm extension)panel of exams,the patient underwent a surgical exclusion of the giant CAA and a coronary artery bypass grafting(CABG)by using the left thoracic mammary artery(LITA).The hospitalization was uneventful,and the patient left the hospital completely asymptomatic.In conclusion,even in cases of giant coronary aneurysms,the treatment is surgical by excluding the aneurismatic sac and performing a surgical revascularization.
基金Supported by Science and Technology Program of Sichuan,No.2019YFS0239.
文摘Kawasaki disease(KD)is an acute systemic vasculitis characterized by unknown etiology.CASE SUMMARY A 4.5-year-old boy developed an acute abdomen during the onset of incomplete KD.He still had persistent abdominal pain after undergoing exploratory laparotomy and appendectomy.Ultrasound examination at early onset revealed a giant coronary artery aneurysm.The patient developed a myocardial infarction and heart failure accompanied by respiratory and cardiac arrest.He underwent coronary artery revascularization and coronary artery bypass graft using an autologous internal mammary artery.After the operation,the cardiac output increased,and the symptoms of heart failure resolved.Follow-up evaluation at 1 mo after operation showed that the patient's cardiac function had restored to New York Heart Association standard Grade I heart failure,and normal growth was obtained.CONCLUSION Coronary artery revascularization and coronary artery bypass graft is an effective method for treating myocardial ischemia in children with KD complicated with giant coronary artery aneurysm.Nevertheless,some issues still need specific attention.
