ABSTRACT
The authors present a case of a large saccular aneurysm in a coronary artery fistula originating from the proximal left anterior descending coronary artery, draining into the main trunk of the pulmonary artery. The diagnosis was made by 3-dimensional computed tomography and coronary arteriography. Congenital coronary artery fistula is not uncommon. With a saccular aneurysm, however, it is very rare. A ruptured aneurysm will induce sudden death if surgical repair is not done.
Subject(s)
Coronary Aneurysm/congenital , Coronary Angiography , Coronary Vessel Anomalies/diagnostic imaging , Image Processing, Computer-Assisted , Imaging, Three-Dimensional , Pulmonary Artery/abnormalities , Tomography, X-Ray Computed , Aged , Aged, 80 and over , Coronary Aneurysm/diagnostic imaging , Diagnosis, Differential , Echocardiography , Humans , Male , Pulmonary Artery/diagnostic imaging , Sensitivity and SpecificityABSTRACT
A 73-year-old man with bradycardia and atrial fibrillation underwent implantation of a transvenous pacemaker system on the left anterior chest wall in 1995. Six years later, he was admitted for bacteremia from coagulase-negative Staphylococcus. Repeated treatment employing antibiotic therapy was ineffective. The infected electrode was removed under cardiopulmonary bypass. His electrode had become firmly encased with fibrous tissue within the right ventricle and atrium. It was removed under direct vision during complete cardiac arrest. The postoperative course was uneventful and there has been no recurrence after 1 year.
