title: Complete proximal occlusion of all three main coronary arteries complicated with a left main coronary aneurysm: a case report.
abstract: A 68-year-old woman with recurrent chest pain was referred to our institution. Coronary angiography showed 100% obstruction of the left main trunk, the proximal right coronary artery with good collaterals to the left anterior descending artery and left circumflex artery along the conus artery. Emergency surgical revascularization was undertaken with two saphenous vein grafts. The saphenous vein grafts were placed in the left anterior descending artery, obtuse marginal branch and the posterolateral and posterior descending coronary arteries with excellent flow. The postoperative course was uneventful and follow-up angiography was obtained 20 days after the surgery. Coronary angiography demonstrated a saccular aneurysm (10 x 9 mm) originating at the distal segment of the left main coronary artery with 90% stenosis, and excellent patency of both saphenous vein grafts. Follow-up angiography was performed 1 and 3 years after the surgery. The size of the left main coronary aneurysm remained unchanged at both examinations. The patient did well with no further cardiac symptoms after 5 years.
authors.affiliation: Division of Cardiology, Tokuyama Central Hospital, Koda-cho 1-1, Shunan, Yamaguchi 745-0822.
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Wakeyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ogawa
authors.forename: Akira
authors.initials: A
authors.lastname: Takaki
authors.forename: Takahiro
authors.initials: T
authors.lastname: Iwami
authors.forename: Masayasu
authors.initials: M
authors.lastname: Kimura
authors.forename: Takeo
authors.initials: T
authors.lastname: Tanaka
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Uchinoumi
mesh_terms: D003323:Coronary Aneurysm / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000379:methods; D003327:Coronary Disease / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D012501:Saphenous Vein / Q000637:transplantation; D014654:Vascular Patency