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Eur J Cardiothorac Surg 2003;24:641
© 2003 Elsevier Science NL

Images in cardio-thoracic surgery

Aneurysmal coronary artery disease of the right coronary artery

Torsten Bossert*, Roberto Battellini, Jan Fritz Gummert, Friedrich Wilhelm Mohr

Department of Cardiac Surgery, University of Leipzig, Heart Center, Leipzig, Germany

Received 23 May 2003; received in revised form 17 June 2003; accepted 14 July 2003.

* Corresponding author. Tel.: +49-341-8651421; fax: +49-341-8651452
e-mail: tbossert11{at}aol.com

Key Words: Coronary artery aneurysm • Atheriosclerosis • Coronary artery bypass

Coronary artery aneurysms are uncommon, with male dominance and uncertain natural history. The RCA is predilected in 50% of cases. Complications are thrombus, risk of rupture and vasospasm. Treatment is not clearly defined, only anecdotal experience exists. We treated two elder male patients with isolated large aneurysm of the RCA (Fig. 1 a,b) presented with syncope and postinfarct angina, respectively. We performed excision of the aneurysm and anastomosed the right internal mammaria artery end to side. Postoperative courses were uneventful. Histological investigation revealed atherosclerotic aneurysms.



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  		Fig. 1. Isolated large coronary artery aneurysms of the RCA in two patients (a and b) in the right anterior oblique view. The left coronary system was not diseased.

 




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