Post-angioplasty aneurysm of right coronary artery
Post-PTCA coronary artery aneurysm
Uberto Da Col, MD, Stefano Pasquino, MD, Isidoro Di Bella, MD, Davide Di
Lazzaro, MD
Dept. of Cardiac Surgery, Ospedale Santa Maria della misericordia,
Azienda Ospedaliera di Perugia, Perugia Italy
Corresponding author: Davide Di Lazzaro, S.C. di Cardiochirurgia
Ospedale Santa Maria della Misericordia, S. Andrea delle fratte 06156
Perugia Italy
e-mail:davide.dilazzaro@ospedale.perugia.it
Telephone: +39 0755782300 Fax: +39 0755782352
Abstract
Coronary artery aneurysms are an uncommon disease whose incidence ranges
from 0.3% to 5.3%. The right coronary artery is affected in 40-70% of
cases. Percutaneous coronary angioplasty is among causative factors, in
particular with stent implantation. We present a case of large
post-angioplasty aneurysm of the right coronary artery requiring
surgical correction.
Coronary artery aneurysms are an uncommon disease whose incidence ranges
from 0.3% to 5.3%1. The right coronary artery is
affected in 40-70% of cases. Percutaneous coronary angioplasty is among
causative factors, in particular with stent implantation; its incidence
ranges from 1.25% to 3.9%.2,3
A 70-year-old man with history of multiple coronary angioplasty
procedures was admitted with diagnosis of aneurysm of the right coronary
artery at the site of past DES insertion (Figure).
Under cardiopulmonary bypass, the large aneurysm was incised and
oversewn with final grafting of the posterior descending artery with in
situ right internal mammary artery.
IRB approval: N/A
Informed consent: N/A
References
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ST. Frequency and Outcome of Development of Coronary Artery Aneurysm
After Intracoronary Stent Placement and Angioplasty. Am J
Cardiol 1997;79:1104–6.
- Ahn C-M, Hong B-K, Kim J-Y, Min P-K, et al. Incidence and natural
history of coronary artery aneurysm developing after drug-eluting
stent implantation. Am Heart J 2010;160:987–94.
Figure: A: pre-PTCA ectatic RCA; B: post-PTCA true RCA aneurysm; C:
surgical view: aneurysm; D: aneurysm’s content; E: arrows showing RCA
(bottom left) and PDA, aneurysm in between; F; RIMA in situ graft to
PDA, repaired aneurysm. RA: right atrium; AO: aorta; PDA: posterior
descending artery; RCA: right coronary artery