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Eur J Cardiothorac Surg 2002;22:144
© 2002 Elsevier Science NL

Images in cardio-thoracic surgery

An aneurysm of the left main coronary artery associated with a Stanford type B aortic dissection

Denyan Mansuroglu*, Suat Nail Ömeroglu, Kaan Kirali, Gökhan Ipek

Department of Cardiovascular Surgery, Kouyolu Heart and Research Hospital, Istanbul, Turkey

Received 4 January 2002; received in revised form 11 March 2002; accepted 22 March 2002.

* Corresponding author. Tel.: +90-532-6777646; fax: +90-216-3390441
e-mail: kosuyolu{at}superonline.com

Key Words: Aneurysm of coronary artery • Aneurysm of left main coronary artery • Aortic dissection

A hypertensive 57-year-old-man presented with sudden back pain. On computed tomographic and transesophageal echocardiographic (Fig. 1 ) examinations, a Stanford type B aortic dissection was detected. A coronary arteriogram and aortogram (Fig. 2 ) revealed a rare combination of an ‘aneurysm of the left main coronary artery’ that extended to both proximal left anterior descending and circumflex arteries, with an ‘aortic dissection’ beyond the left subclavian artery.



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  		Fig. 1. (a) The computed tomography imaging showing dissection of the descending aorta. (b) Transesophageal echocardiography revealing the flap of a Stanford type B aortic dissection.

 


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  		Fig. 2. (a, b) The coronary arteriogram and aortogram showing an aneurysm of the left main coronary artery and a Stanford type B aortic dissection.

 




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