From Small Coronary Artery Aneurysm to Giant Left Ventricle Aneurysm.
OBJECTIVE
To underscore how challenging the treatment of a coronary artery aneurysm (CAA) can be and highlight the need for consensus guidelines based on focused registries.


METHODS
A 58-year-old man presented with acute coronary syndrome and underwent elective stent placement on a right CAA. The procedure was complicated by inferior acute myocardial infarction; 8 months later, due to remodeling toward a left ventricular aneurysm of the inferior wall, he experienced several episodes of sustained ventricular tachycardia that required urgent surgical treatment.


CONCLUSIONS
The best therapeutic option for CAA is still a matter of controversy, and though the percutaneous approach can meet the technical challenges, 'heart team'-based decision-making is recommended. The case reported here showed that percutaneous treatment of CAA can be a challenging procedure, even in experienced and high-volume centers. In our patient's case, undersizing the covered stent led to further migration and to a complication that was more severe than the original disease.
Cardiac Surgery and Heart Transplantation Unit, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy.
Sergio
S
Sciacca
Giuseppe Maria
GM
Raffa
Giovanni
G
Gentile
Michele
M
Pilato
D003323:Coronary Aneurysm / Q000150:complications* / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004452:Echocardiography; D005548:Foreign-Body Migration / Q000150:complications; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications; D011183:Postoperative Complications; D016896:Treatment Outcome