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At least 19 recordsLinked to original sources
PubMed2005

Intracranial aneurysms, coronary aneurysms and descending aortic coarctation--unreported association.

Rare association of coronary artery aneurysms with intra cranial aneurysms is reported. Also, association of abdominal aortic coarctation with intracranial aneurysms is rare. A 70-year-old female presented with subarachnoid hemorrhage secondary to rupture of intracranial aneurysm. On evaluation, she was found to have intracranial aneurysms in the vertebral and basilar artery, coronary aneurysms and descending thoracic aortic coarctation. This association is unreported.

Abnormalities, Multiple↗
PubMed2005

Reoperation for ascending aortic aneurysm, coronary ostial aneurysm and patent Cabrol trick after bentall operation for aortitis syndrome.

A 38-year-old woman who had undergone an original Bentall operation in December 1995 for annuloaortic ectasia associated with ulcerative colitis required reoperation for ascending aortic aneurysm, coronary ostial aneurysm, and patent Cabrol trick. The initial Bentall operation included aortic root replacement using a valved conduit and reconstruction of the coronary arteries. Both coronary ostia were directly anastomosed to the composite valved graft, which was wrapped with the dilated aortic wall, and a Cabrol trick was added at the same time. She underwent reoperation for a 60 mm ascending aortic aneurysm which had been used for wrapping at the initial operation. The findings at reoperation were a patent Cabrol trick, leakage from the distal anastomosis, aneurysm of both coronary ostia, and paravalvular leakage. The repairs included graft replacement, leaving the valvular prosthesis, reconstruction of both coronary arteries by the Piehler method and Carrel patch technique, repair of the paravalvular leakage, and closure of the Cabrol trick. Her postoperative course was uneventful, and the serum concentration of C-reactive protein remained within normal limits. Strict follow-up care is required to avoid further anastomotic dehiscence.

Aortic Aneurysm↗
PubMed1998

Congenital and Atherosclerotic (Acquired) Coronary Artery Aneurysms: Coronary Angiographic and Morphologic Observations in 10 Patients

Coronary angiographic observations in 10 patients with coronary artery aneurysms (CAAs) are reported. Four patients had atherosclerotic (acquired) and six had congenital CAAs. The mean age of patients with acquired CAAs was higher (64.7 years) compared with the congenital group (53.2 years). Ipsilateral myocardial infarction (MI) occurred in three of four patients with acquired CAAs but MI was not located on the same side as the aneurysm-bearing coronary artery (contralateral) in two patients with the congenital variety. In the patients with congenital CAAs, an aneurysm predilection site was observed in the proximal portion of the aneurysm-bearing vessel. Dual and multiple aneurysms were more common in the acquired CAAs. Although congenital CAAs were sizeable, the small-sized atherosclerotic CAAs developed complications more frequently. During an average follow-up of 7.9 years, only one patient died of a noncardiac cause and another developed recurrent uncomplicated non-Q wave lateral MI. Both subjects had atherosclerotic CAAs. In our series, no rupture or sudden death occurred. Coronary artery bypass grafting (CABG) was performed in three patients with acquired and in one patient with congenital CAAs. In the latter patient, simultaneous ligation of the congenital aneurysm associated with a coronary arteriovenous fistula was performed. Regarding antiplatelet and anticoagulant policy for the whole group, three patients were on aspirin, four were on acenocoumarol, and in another three subjects with congenital CAAs, a medical regimen was followed. Larger series, however, are required in order to elucidate further angiographic characteristics of acquired vs congenital CAAs.

Journal Article↗
PubMedDate not supplied

Noninvasive evaluation of a fistula between a giant coronary aneurysm and coronary sinus performed via multidetector row computed tomography.

Coronary artery fistula (CAF) is an uncommon anomaly of congenital and rarely iatrogenic etiology. Most of the patients are asymptomatic, and the anomaly is incidentally recognized during a coronary angiography performed for other reasons. Also, coronary artery aneurysms are rare. We report a case of CAF associated with a giant aneurysm evaluated using multidetector row computed tomography.

Aged↗
PubMed2006

Coronary aneurysm reduced after coronary stenting.

We describe as case of a 70-year-old man who underwent a percutaneous coronary intervention with stenting, for a severe stenosis complicated by a coronary aneurysm just distal to the stenotic site. Notably, coronary angiogram showed an immediate and progressive reduction in the size of coronary aneurysm. Curved planar reconstruction images of the enhanced CT showed no thrombus and no dissection of the coronary aneurysm. We speculate that coronary stenting might decrease the velocity of coronary flow through the stenosis. Consequently, stenting might attenuate the hydrodynamic wall stress on the aneurysm, and, in addition, improve the degradation of the extracellular matrix structure through the regulation of matrix metalloproteinases. Regression of coronary aneurysm after stenting requires further investigations, because stenting may become a potential means for treating post-stenotic aneurysms.

Aged↗
PubMed1998

A huge coronary aneurysm resulting from a coronary artery-to-left ventricle fistula.

A huge coronary aneurysm resulting from a coronary artery-to-left ventricle fistula is a rare condition. A 57-year-old male had severe recurrent angina attacks. The cause of angina pectoris was a right coronary artery-to-left ventricle fistula with a huge coronary aneurysm. The histological examination of surgically excised specimens revealed that two vertical smooth muscle layers of media of the aneurysm might be associated with dysplasia. Mucoid degeneration was also shown in the intima and around the vasa-vasorum. Abnormal hemodynamics related to the fistula might have induced these vessel wall changes resulting in the huge coronary aneurysm.

Angina Pectoris↗
PubMed2000

Interposition vein graft for giant coronary aneurysm repair.

Coronary aneurysms in adults are rare. Surgical treatment is often concomitant to treating obstructing coronary lesions. However, the ideal treatment strategy is poorly defined. We present a case of successful treatment of a large coronary artery aneurysm with a reverse saphenous interposition vein graft. This modality offers important benefits over other current surgical and percutaneous techniques and should be considered as an option for patients requiring treatment for coronary aneurysms.

Adult↗
PubMed1997

Plaque rupture as a cause of apparent coronary aneurysm formation following directional coronary atherectomy.

Late coronary aneurysm formation was observed following treatment by directional coronary atherectomy. Intravascular ultrasound disclosed that the mechanism involved was plaque rupture. The cause of coronary aneurysm may be multifactorial after coronary interventions. Intravascular ultrasound imaging is useful for understanding the pathologic mechanism of coronary aneurysm production.

Aortic Dissection↗
PubMed2002

Polymorphisms in the promoter regions of MMP-2, MMP-3, MMP-9 and MMP-12 genes as determinants of aneurysmal coronary artery disease.

OBJECTIVES: Our hypothesis was that functional polymorphisms in matrix metalloproteinase (MMP) genes may act as susceptibility factors for the development of coronary aneurysms (CAs). BACKGROUND: Different forms of remodeling have been described at the level of coronary arteries; CA, reported in 1% to 5% of patients with angiographic evidence of coronary artery disease (CAD), are one of them. Matrix metalloproteinases have been implicated in the pathogenesis of aneurysm development through increased proteolysis of extracellular matrix proteins. METHODS: We screened 3,862 patients who underwent coronary angiography and identified 113 patients with CAD with at least one CA (CA group); these patients were matched with 226 patients with CAD without CA (control group). The -1,306 C/T MMP-2, 5A/6A MMP-3, CA-repeat MMP-9 and -82 A/G MMP-12 polymorphisms were determined. RESULTS: The MMP-2, MMP-9 and MMP-12 polymorphisms were not associated with CA. By contrast, the 5A/5A genotype of MMP-3 was significantly more frequent in the CA group than in the control group (31% vs. 18%, p = 0.015); similarly, the MMP-3 5A allele was more frequent in the CA group (p = 0.009). Three variables were independently associated with CA: the MMP-3 5A/5A genotype (odds ratio [OR] = 2.23, 95% confidence interval [CI] [1.27 to 3.93]), a previous myocardial infarction (OR = 1.91, 95% CI [1.14 to 3.20]) and a history of aortic aneurysm (OR = 21.06, 95% CI [2.35 to 188]). CONCLUSIONS: The MMP-3 5A allele is associated with the occurrence of CA. Our results suggest that an increased proteolysis in the arterial wall may act as a susceptibility factor for the development of CA in patients with coronary atherosclerosis.

Alleles↗
PubMed2002

[Giant left main coronary aneurysm without associated coronary lesions].

Left main coronary artery aneurysms are very infrequent (0.1%) and the majority are related to atherosclerotic obstructive lesions. Only a few isolated cases without associated coronary lesions have been reported until now. The management of these patients is not well established, thus both conservative and surgical treatments have been postulated. We present a case of giant left main coronary artery aneurysm with a diameter of 27.7 x 18.6 mm (the biggest reported until now) without coronary tree associated stenosis. It was treated conservatively with oral anticoagulation only and the 5 years evolution has been favourable.

Adult↗
PubMed1990

Late coronary aneurysm formation following coronary angioplasty.

In a 38-year-old man with recurrent chest pain 14 months following percutaneous transluminal coronary angioplasty (PTCA) of the left anterior descending coronary artery, two aneurysms were noted at previous PTCA sites without evidence of restenosis. Although the precise mechanism of formation of these aneurysms is not known, it is possible that medial dissection and weakening of the artery provoked aneurysm formation.

Adult↗
PubMed2001

[A case of surgical treatment for cardiac tamponade caused by a ruptured coronary aneurysm accompanied by a coronary artery-pulmonary artery fistula].

A 67-year-old woman experienced a sudden severe pain in the area of her left shoulder and back. Three days later the pain recurred, after which she fell into shock and was taken to another hospital by ambulance. A plain chest CT scan showed a cardiac tamponade, while an enhanced chest CT scan demonstrated a coronary aneurysm in the left anterior descending branch draining to the pulmonary artery. Coronary arteriography revealed a saccular type aneurysm, 5 cm in diameter, with a coronary artery-pulmonary artery fistula. After pericardiocentesis, she recovered from her state of shock. The patient was then transferred to our hospital, where she underwent emergency surgery. Under a cardiopulmonary bypass, the stem of the aneurysm and the fistula were ligated and resected. She recovered smoothly and was discharged on the 24th postoperative day.

Aged↗
PubMed2003

Multiple coronary aneurysms resulting from isolated coronary vasculitis in an elderly patient.

An 81-year-old man developed multiple coronary aneurysms, including the left main truncus, that were unexpectedly found by coronary angiography. He had been followed-up for 14 years because of angina pectoris; his initial coronary angiograms in 1985 showed some stenotic segments but no aneurysmal changes. The patient died of gastric cancer in March 2000. On microscopic examination of the coronary arteries, the prominent feature was an inflammatory reaction in the medial layer, comprising chiefly small lymphocytes and plasma cells. The internal and the external elastic membranes were destroyed, presumably causing the aneurysmal dilatation of the vessels. There was a moderate degree of concomitant atherosclerotic fibrointimal thickening. No evidence of vasculitis was seen in sections of the aorta, peripheral arteries, and other major organs. The present case is unique because the cellular infiltrates were confined to the coronary media and although a definite diagnosis was not made, it was probably an atypical form of vasculitic disease; namely, isolated coronary vasculitis.

Aged↗
PubMed2006

[Large coronary aneurysm diagnosed during an acute coronary syndrome. A case report and review of the literature].

Coronary aneurysm is an uncommon variant of coronary atherosclerosis. It usually involves the right coronary artery and is often associated with significant coronary stenosis. It may be revealed by an acute coronary syndrome (ACS). We report the case of a 49 year-old woman in whom a large coronary aneurysm of the left anterior descending artery was revealed by an ACS. Coronary angiography remains the gold standard diagnosis procedure, but spiral computed tomography may be of interest to specify the location and nature of the aneurysm, and thus guide surgical or percutaneous treatment.

Angina, Unstable↗
PubMed1982

Fate of coronary aneurysms in Kawasaki disease: serial coronary angiography and long-term follow-up study.

Between January 1973 and December 1979, 290 patients with Kawasaki disease were evaluated with coronary angiography after the acute stage of illness. Of these patients, 43 (15 percent) were diagnosed as having coronary aneurysms. Forty-two patients have been followed up for an average of 4 years (range 15 months to 8 years). One 8 month old girl died of myocardial infarction after 4 months of illness. Follow-up coronary angiography was performed in 42 patients 5 to 18 months after the acute illness. Four groups can be distinguished. Group I: In 21 (50 percent) of 42 patients angiography showed that the coronary aneurysms had regressed, so that no observable lesions were seen. During convalescence, electrocardiography, exercise stress testing and thallium scintigraphy were within normal limits. In the other 21 patients abnormal findings persisted on follow-up angiography. Group II: Ten patients showed persistent coronary aneurysms, although reduced in size. Group III: In seven patients the aneurysms had disappeared, but complete obstruction or marked stenosis of coronary arteries was found. Group IV: In four patients, irregularities of the coronary arterial wall without stenosis were seen. Among patients with abnormal angiographic findings myocardial infarction and mitral regurgitation were also seen. Early initiation of aspirin therapy aneurysms show regression on angiography in 1 or 2 years in about half of patients. The remaining patients are at risk for ischemic heart disease. Thus, Kawasaki disease should be considered an important cause of ischemic heart disease in children and a possible risk factor of premature coronary atherosclerosis.

Cardiac Output↗