Incidental Diagnosis of a Giant Coronary Artery Pseudoaneurysm / 日本心臓血管外科学会雑誌

ABSTRACT

Coronary artery pseudoaneurysms are rare, and usually present as long-term complications of percutaneous coronary intervention or coronary artery bypass grafting, or as a side effect of systemic vasculitis, including Behçet disease. A 60-year-old man was admitted to our hospital due to a hemorrhagic duodenal ulcer. As a mucosal bulge at the fornix was detected on upper gastrointestinal endoscopy, the patient underwent a further examination of other organs using computed tomography. Coronary computed tomography and coronary angiography revealed a right coronary artery aneurysm with a maximum diameter of 43 mm and 90% stenosis in the left anterior descending artery. The patient successfully underwent coronary artery aneurysmectomy and coronary artery bypass grafting of the left anterior descending artery using the left mammary artery. The pathological findings were consistent with those of a pseudoaneurysm. In the present case, the coronary pseudoaneurysm may have been due to traumatic because he had experienced neither coronary treatments nor systemic vasculitis, although he had suffered blunt trauma that involved splenectomy 30 years earlier.