Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
Abstract Background The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic i...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | BMC Surgery |
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| Online Access: | http://link.springer.com/article/10.1186/s12893-019-0547-z |
| _version_ | 1828872324851433472 |
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| author | Jiayu Shen Yang Zhou Zhi Fang Jia Hu |
| author_facet | Jiayu Shen Yang Zhou Zhi Fang Jia Hu |
| author_sort | Jiayu Shen |
| collection | DOAJ |
| description | Abstract Background The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instability who was diagnosed with multiple giant CAAs combined with RCA-PA fistula. Case presentation The patient, a 60-year-old female, presented to the emergency room because of progressive exertional chest distress and fatigue. The transthoracic echocardiography (TTE), coronary computed tomography angiography (CTA) and invasive coronary angiography confirmed the existence of multiple giant CAAs and RCA-PA fistula. Laboratory examinations for systemic vasculitis and infectious diseases demonstrated no abnormalities and work-up for childhood and family history were negative. We have performed a successful surgical treatment for this patient. The patient’s restrictive cardiac dysfunction was improved after debriding the advanced thrombi in aneurysm sac and ligating the fistulous vessel between the native RCA and PA. The postoperative pathologic examination of the aneurysmal wall revealed loss of smooth muscle cells in the media with local mucoid degeneration, no chronic inflammation, sclerosis and IgG4 were observed. Conclusions The treatment decision-making process should depend upon the patients’ specific situations. Our case suggests the surgical intervention should be accepted as the preferred treatment for giant CAAs with restrictive cardiac dysfunction. |
| first_indexed | 2024-12-13T06:51:36Z |
| format | Article |
| id | doaj.art-b92d16e118a6407f9d9e356aeb22b800 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-12-13T06:51:36Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-b92d16e118a6407f9d9e356aeb22b8002022-12-21T23:56:08ZengBMCBMC Surgery1471-24822019-07-011911510.1186/s12893-019-0547-zMultiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case reportJiayu Shen0Yang Zhou1Zhi Fang2Jia Hu3Department of Cardiovascular Surgery, West China Hospital of Sichuan UniversityDepartment of Cardiothoracic Surgery, People’s Hospital of LeshanDepartment of Cardiovascular Surgery, West China Hospital of Sichuan UniversityDepartment of Cardiovascular Surgery, West China Hospital of Sichuan UniversityAbstract Background The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instability who was diagnosed with multiple giant CAAs combined with RCA-PA fistula. Case presentation The patient, a 60-year-old female, presented to the emergency room because of progressive exertional chest distress and fatigue. The transthoracic echocardiography (TTE), coronary computed tomography angiography (CTA) and invasive coronary angiography confirmed the existence of multiple giant CAAs and RCA-PA fistula. Laboratory examinations for systemic vasculitis and infectious diseases demonstrated no abnormalities and work-up for childhood and family history were negative. We have performed a successful surgical treatment for this patient. The patient’s restrictive cardiac dysfunction was improved after debriding the advanced thrombi in aneurysm sac and ligating the fistulous vessel between the native RCA and PA. The postoperative pathologic examination of the aneurysmal wall revealed loss of smooth muscle cells in the media with local mucoid degeneration, no chronic inflammation, sclerosis and IgG4 were observed. Conclusions The treatment decision-making process should depend upon the patients’ specific situations. Our case suggests the surgical intervention should be accepted as the preferred treatment for giant CAAs with restrictive cardiac dysfunction.http://link.springer.com/article/10.1186/s12893-019-0547-zCoronary artery aneurysmPulmonary artery fistulaRestrictive cardiac dysfunction |
| spellingShingle | Jiayu Shen Yang Zhou Zhi Fang Jia Hu Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report BMC Surgery Coronary artery aneurysm Pulmonary artery fistula Restrictive cardiac dysfunction |
| title | Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report |
| title_full | Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report |
| title_fullStr | Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report |
| title_full_unstemmed | Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report |
| title_short | Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report |
| title_sort | multiple giant coronary artery aneurysms combined with right coronary artery pulmonary artery fistula a case report |
| topic | Coronary artery aneurysm Pulmonary artery fistula Restrictive cardiac dysfunction |
| url | http://link.springer.com/article/10.1186/s12893-019-0547-z |
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