Document Detail


Coronary artery aneurysm: management and association with abdominal aortic aneurysm.
MedLine Citation:
PMID:  16533698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Coronary artery aneurysm (CAA) is a dilatation that exceeds 1.5 times the diameter of a normal adjacent coronary artery. Several studies suggest that pathogenetic mechanisms involved in this disease and in abdominal aortic aneurysm (AAA) are similar. Surgery for CAA is mandatory when the aneurysm is three to four times larger than the original vessel diameter. We reviewed our experience in the surgical treatment of this unusual disease and analyzed its association with AAA. MATERIALS AND METHODS: Between October 1993 and March 2005, 11 patients (9 men; mean age=66 years) underwent surgery for CAA. In all cases, coronary aneurysms were diagnosed as incidental findings in coronary angiographies. The coronary aneurysms were isolated and longitudinally incised: the proximal and distal openings were identified and sutured. The sacs were obliterated with running sutures. Myocardial protection was achieved by retrograde cardioplegia only. Coronary artery bypass grafting was performed distally to the excluded aneurysms in all patients. RESULTS: One patient died of respiratory failure early after the operations; all other patients are alive, asymptomatic for angina, and free from repeated acute myocardial infarction after a median follow-up of 76 months (range=4-141 months). A total of six patients underwent surgical repair or endoprosthesis implantation because of AAAs. CONCLUSIONS: Our operative techniques ensured durable results. We recommend screening for abdominal aneurysms in all affected patients because of the frequent association between CAA and AAA as a result of their similar pathogenetic mechanism.
Authors:
Giovanni Mariscalco; Vittorio Mantovani; Sandro Ferrarese; Cristian Leva; Alessandro Orrù; Andrea Sala
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology     Volume:  15     ISSN:  1054-8807     ISO Abbreviation:  Cardiovasc. Pathol.     Publication Date:    2006 Mar-Apr
Date Detail:
Created Date:  2006-03-14     Completed Date:  2006-05-18     Revised Date:  2006-11-03    
Medline Journal Info:
Nlm Unique ID:  9212060     Medline TA:  Cardiovasc Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  100-4     Citation Subset:  IM    
Affiliation:
Department of Surgical Sciences, Cardiac Surgery Division, Varese University Hospital, 21100 Varese, Italy. giovannimariscalco@yahoo.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Angiography
Aortic Aneurysm, Abdominal / complications*
Coronary Aneurysm / complications*,  pathology,  surgery*
Coronary Vessels / pathology,  surgery*
Female
Humans
Male
Middle Aged

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