title: Successful surgical treatment of a giant coronary aneurysm communicating with the right atrium.
abstract: Aneurysms of the coronary arteries are rare events. In most cases, such abnormalities are clinically silent and, when they cause symptoms, there are dyspnea and/or angina. Our report describes a case presenting with dyspnea; the admission electrocardiogram demonstrated largely spread ischemia in the lower-lateral leads and myocardial necrosis in the inferior wall. Selective coronary angiography disclosed severe three-vessel disease; aortic angiography revealed a large vascular neoformation, partly thrombosed, with multilobes and a wide communication with the ascending aorta; the oxygen run showed a slight, non-significant 'jump' at the level of the right atrium, confirming a possible left-to-right shunt. On open chest surgery, these alterations were confirmed. The principal aneurysm (6-7 cm) originating in right auricle gave rise to a localized pseudoaneurysm above the superior vena cava; the other three aneurysmal structures were situated along the course of the right coronary artery. After 2 years of clinical and echocardiographic control, the patient is symptom-free under conventional medical treatment.
authors.affiliation: Divisione Clinicizzata di Cardiologia, Azienda Ospedaliera Maggiore della Carità, Novara, Italy. arognoni@hotmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.forename: Valeria
authors.initials: V
authors.lastname: Ferrero
authors.forename: Giovanni
authors.initials: G
authors.lastname: Teodori
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D003323:Coronary Aneurysm / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D006325:Heart Atria / Q000601:surgery; D006801:Humans; D008026:Ligation; D008297:Male; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*