Amat-Santos, Ignacio J.

Castrodeza, Javier

Laguna, Gregorio

Revilla, Ana

Sevilla, Teresa

English

Via Medica Journals

Address for correspondence: Ana Revilla, MD, PhD, ICICOR, Hospital Clínico Universitario de Valladolid,  C/Ramón y Cajal 3, Valladolid, Spain, tel: +34 983 42 00 26, fax: +34 983 25 53 05, e-mail: arevillaorodea@gmail.comReceived: 08.01.2018 Accepted: 16.01.2018clinical caRDiOlOgyCardiology Journal 2018, Vol. 25, No. 3, 418–419DOI: 10.5603/CJ.2018.0062 Copyright © 2018 Via MedicaISSN 1897–5593418 www.cardiologyjournal.orgIMAGE IN CARDIOVASCULAR MEDICINEAdult woman with giant thrombosed  multiple coronary aneurysmsJavier Castrodeza1, Ana Revilla1, 2, Gregorio Laguna3,  Ignacio J. Amat-Santos1, 2, Teresa Sevilla1, 21Department of Cardiology, ICICOR, Hospital Clínico Universitario, Valladolid, Spain 2CIBER de Enfermedades Cardiovasculares (CIBERCV), Valladolid, Spain 3Department of Cardiac Surgery, Hospital Clínico Universitario, Valladolid, SpainFigure 1. A–H. Image matching of computed tomography scan, angiography, two-chamber view, and surgical view.A 55-year-old Caucasian woman with histo-ry of hypertension, dyslipidemia, and no relevant disease in her childhood was referred for cath-eterization due to a non-ST-elevation myocardial infarction. A transthoracic echocardiogram showed a rounded structure with hyperechogenic limits anterior to the auriculo-ventricular sulcus in the two-chamber view (Fig. 1A). The angiogram re-vealed a three-vessel disease with an aneurysm of the proximal left anterior descendent artery with severe stenosis, a significant stenosis followed by an-other aneurysm in the proximal circumflex (Fig. 1C) and a completely thrombosed aneurysm in the proximal right coronary (Suppl. Video 1 and 2). A multidetector cardiac computed tomogra-phy scan was then performed and revealed a calcified and partially thrombosed aneurysm of 53 mm with a diameter of 29 × 24 mm in the proximal www.cardiologyjournal.org 419Javier Castrodeza et al., Adult woman with giant thrombosed multiple coronary aneurysmsleft anterior descendent (green arrow), another of 17 × 18 mm in the proximal circumflex (red ar-row) and a calcified and thrombosed proximal right coronary aneurysm (blue arrow) with appropriate distal vessels (Fig. 1E–H). Supra-aortic trunks were normal. She underwent surgery for coronary artery by-pass grafting (Fig. 1B, D; Suppl. Video 3), as ste-nosis was the predominant feature, using both internal mammary arteries and a saphenous vein. She was discharged with no incidence.Giant and multiple coronary aneurysms are uncommon in  adulthood. Possible etiologies are atherosclerosis, Kawasaki and Takayasu disease and some systemic and infective disorders. Multi-detector cardiac computed tomography scan is an excellent technique to plan the surgical interven-tion as it allows a complete characterization and evaluation of the aneurysms and distal vessels. Conflict of interest: None declared

Adult woman with giant thrombosed multiple coronary aneurysms

https://journals.viamedica.pl/cardiology_journal/article/download/CJ.2018.0062/44759

Adult woman with giant thrombosed multiple coronary aneurysms

Abstract

Similar works

Full text

Available Versions

Via Medica Journals