Review on Diagnosis and Treatment of Giant Coronary Artery Aneurysm_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

 LIRong , LIWei-guo

Department of Cardiovascular Surgery, Jinzhou Central Hospital, Jinzhou 121000, Liaoning, P. R. china;

Corresponding author：

LIRong, Email: lrlnjz@163.com

Keywords：

Giant coronary artery aneurysm; Atherosclerosis of coronary artery; false coronary artery aneurysm; Coronary angiography; Thromboembolism; Intervention

DOI：

10.7507/1007-4848.20160176

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The diameter of the giant coronary artery aneurysm is at least 4 times bigger than that of the normal coronary artery and 2-3 times bigger than that of the normal coronary artery aneurysm. Giant coronary artery aneurysm is rare in clinic with a reported morbidity which is less than 0.3%. Just like ordinary coronary artery aneurysm, coronary artery atherosclerosis is the main cause of the giant coronary artery aneurysm. Most giant coronary artery aneurysms are asymptomatic, but some patients may have heart-related clinical emergency in short term and may have thrombosis which can lead to embolism and fistula which can cause rupture in long term. Surgical treatment is the first chioce for giant coronary artery aneurysm now. However, the interventional therapy will also be an important way to treat the disease in the future. In this article, we review the diagnosis, clinical manifestation, treatment and other aspects of giant coronary artery aneurysm as follows.

Citation： LIRong, LIWei-guo. Review on Diagnosis and Treatment of Giant Coronary Artery Aneurysm. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(7): 738-741. doi: 10.7507/1007-4848.20160176 Copy

1.	Ipek G, Omeroglu SN, Goksedef D, et al. Giant right coronary artery aneurysm associated with coronary-cameral fistula.Tex Heart Inst, 2012, 39(3):442-443.
2.	Al Salihi S, Jacobi E, Hunter R, et al. Multiple giant coronary artery aneurysms:a case report. Cardiovasc Pathol, 2016, 25(3):203-207.
3.	Alford WC, Stoney WS, Burrus GR, et al. Recognition and operative management of patients with arteriosclerotic coronary artery aneur-ysms. Ann Thorac Surg, 1976, 22(4):317-321.
4.	Anfinsen OG, Aaberge L, Geiran O, et al. Coronary artery aneurysms mimicking cardiac tumor. Eur J Echocardiogr, 2004, 5(4):308-312.
5.	Chia HM, Tan KH, Jackson G. Nonatherosclerotic coronary artery aneurysms:two case reports. Heart, 1997, 78(6):613-616.
6.	Eshtehardi P, Cook S, Moarof I, et al. Giant coronary artery aneurysm:imaging findings before and after treatment with a polytetrafluoroe-thylene-covered stent. Circ Cardiovasc Inter, 2008, 1(1):85-86.
7.	Gundogdu F, Arslan S, Buyukkaya E, et al. Treatment of a coronary artery aneurysm by use of a covered stent graft-a case report. Angiol, 2007, 16(1):31-32.
8.	Robinson FC. Aneurysms of the coronary arteries. Am Heart, 1985, 109(1):129-135.
9.	Demopoulos VP, Olympios CD, Fakiolas CN, et al. The natural history of aneurysmal coronary artery disease. Heart, 1997, 78(2):136-141.
10.	Cohen P, O'Gara PT. Coronary artery aneurysms:a review of the natural history,pathophysiology and management. Cardiol Rev, 2008, 16(6):301-304.
11.	Keyser A, Hilker MK, Husser O, et al. Giant coronary aneurysms exceeding 5 cm in size. Interact Cardiovasc Thorac Surg, 2012, 15(1):33-36.
12.	Takeda K, Matsumiya G, Nishimura M, et al. Giant circumflex coronary artery aneurysm associated with cystic medial necrosis in a non-Marfan patient. Ann Thorac Surg, 2007, 83(2):668-670.
13.	Aqel RA, Zoghbi GJ, Iskandrian A. Spontaneous coronary artery dissection, aneurysms, and pseudoaneurysms:a review. Echocardio-graphy, 2004, 21(2):175-182.
14.	Cafri C, Gilutz H, Kobal S, et al. Rapid evolution from coronary dissection to pseudoaneurysm after stent implantation:a glimpse at the pathogenesis using intravascular ultrasound. Invasive Cardiol, 2002, 14(5):286-289.
15.	Aoki J, Kirtane A, Leon MB, et al. Coronary artery aneurysms after drug-eluting stent implantation. JACC Cardiovasc Interv, 2008, 1(1):14-21.
16.	Garrand TJ, Mintz GS, Popma JJ, et al. Intravascular ultrasound diagnosis of a coronary artery pseudoaneurysm following percutan-eous transluminal coronary angioplasty. Am Heart J, 1993, 125(3):880-882.
17.	Pahlavan PS, Niroomand F. Coronary artery aneurysm:a review. Clin Cardiol, 2006, 29(10):439-443.
18.	Vranckx P, Pirot L, Benit E. Giant left main coronary artery aneurysm in association with severe atherosclerotic coronary disease. Cathet Cardiovasc Diagn, 1997, 42(1):54-57.
19.	Ling Y, Ruan W, Tang M, et al. Giant aneurysm in coronary right ventricular fistula associated with severe tricuspid insufficiency in an adult. Eur Heart, 2016, 22(1):40.
20.	Lazar JF, Compton M, Li F, et al. Excising a giant:report of a 7 cm coronary artery aneurysm. Tex Heart Inst J, 2013, 40(2):173-175.
21.	Jha NK, Ouda HZ, Khan JA, et al. Giant right coronary artery aneurysm-case report and literature review. Cardiothorac Surg, 2009, 4:18.
22.	Zoneraich S, Zoneraich O, Rhee JJ, et al. Giant coronary artery aneurysm. The cause of middiastolic murmur and bulging of the left cardiac border. JAMA, 1975, 231(2):179.
23.	Morita H, Ozawa H, Yamazaki S, et al. A case of giant coronary artery aneurysm with fistulous connection to the pulmonary artery:a case report and review of the literature. Intern Med, 2012, 51(11):1361-1366.
24.	Mata KM, Fernandes CR, Floriano EM, et al. Novel strategies in ischemic heart disease. Intech, 2012, 381-404.
25.	Nazareth J, Weinberg L, Fernandes J, et al. Giant right coronary artery aneurysm presenting with non-ST elevation myocardial infarction and severe mitral regurgitation:a case report. Med Case Rep, 2011, 5:442.
26.	Kelley MP, Carver JR. Coronary artery aneurysms. Invasive Cardiol, 2002, 14(8):461-462.
27.	Maehara A, Mintz GS, Ahmed JM, et al. An intravascular ultrasound classification of angiographic coronary artery aneurysms. Am Cardiol, 2001, 88(4):365-370.
28.	Ge J, Liu F, Gorge G, et al. Intravascular ultrasound approach to the diagnosis of coronary artery aneurysms. Am Heart, 1995, 130(4):765-771.
29.	Szalat A, Durst R, Cohen A, et al. Use of polytetrafluoroethylene-covered stent for treatment of coronary artery aneurysm. Catheter Cardiovasc Interv, 2005, 66(2):203-208.
30.	Izutani H, Shibukawa T, Kawamoto J, et al. Spontaneous right coronary artery pseudoaneurysm. Gen Thorac Cardiovasc Surg, 2007, 55(6):259-261.
31.	Pavlidis AN, Malakos JS, Karavolias GK, et al. Left main coronary artery aneurysm. Herz, 2012, 37(5):565-566.
32.	Chrissoheris MP, Donohue TJ, Young RS, et al. Coronary artery aneurysms. Cardiol Rev, 2008, 16(3):116-123.
33.	Banerjee P, Houghton T, Walters M, et al. Giant right coronary artery aneurysm presenting as a mediastinal mass. Heart, 2004, 90(9):50.
34.	Olson JP, Chamusco RF. Giant left main coronary artery aneurysm initially seen as an acute coronary syndrome. Am Heart J, 1995, 129(6):1216-1217.
35.	Daoud AS, Pankin D, Tulgan H, et al. Aneurysms of the coronary artery. Report of ten cases and review of literature. Am J Cardiol, 1963, 11:228-237.
36.	Newcomb EW, Youngman DJ, Burton NA, et al. Atherosclerotic aneurysm of the left main coronary artery. Am Coll Cardiol, 1984, 4(5):1062-1064.
37.	Zeb M, McKenzie DB, Scott PA, et al. Treatment of coronary aneur-ysms with covered stents:a review with illustrated case. Invasive Cardiol, 2012, 24(9):465-469.
38.	Bhindi R, Testa L, Ormerod OJ, et al. Rapidly evolving giant coronary aneurysm. Am Coll Cardiol, 2009, 53(4):372.
39.	Pradhan A, sharma AK, Jain N, et al. Giant coronary arterial aneur-ysm after drug-eluting stent implantation. Case Rep, 2016, 5(4):214488.

1. Ipek G, Omeroglu SN, Goksedef D, et al. Giant right coronary artery aneurysm associated with coronary-cameral fistula.Tex Heart Inst, 2012, 39(3):442-443.
2. Al Salihi S, Jacobi E, Hunter R, et al. Multiple giant coronary artery aneurysms:a case report. Cardiovasc Pathol, 2016, 25(3):203-207.
3. Alford WC, Stoney WS, Burrus GR, et al. Recognition and operative management of patients with arteriosclerotic coronary artery aneur-ysms. Ann Thorac Surg, 1976, 22(4):317-321.
4. Anfinsen OG, Aaberge L, Geiran O, et al. Coronary artery aneurysms mimicking cardiac tumor. Eur J Echocardiogr, 2004, 5(4):308-312.
5. Chia HM, Tan KH, Jackson G. Nonatherosclerotic coronary artery aneurysms:two case reports. Heart, 1997, 78(6):613-616.
6. Eshtehardi P, Cook S, Moarof I, et al. Giant coronary artery aneurysm:imaging findings before and after treatment with a polytetrafluoroe-thylene-covered stent. Circ Cardiovasc Inter, 2008, 1(1):85-86.
7. Gundogdu F, Arslan S, Buyukkaya E, et al. Treatment of a coronary artery aneurysm by use of a covered stent graft-a case report. Angiol, 2007, 16(1):31-32.
8. Robinson FC. Aneurysms of the coronary arteries. Am Heart, 1985, 109(1):129-135.
9. Demopoulos VP, Olympios CD, Fakiolas CN, et al. The natural history of aneurysmal coronary artery disease. Heart, 1997, 78(2):136-141.
10. Cohen P, O'Gara PT. Coronary artery aneurysms:a review of the natural history,pathophysiology and management. Cardiol Rev, 2008, 16(6):301-304.
11. Keyser A, Hilker MK, Husser O, et al. Giant coronary aneurysms exceeding 5 cm in size. Interact Cardiovasc Thorac Surg, 2012, 15(1):33-36.
12. Takeda K, Matsumiya G, Nishimura M, et al. Giant circumflex coronary artery aneurysm associated with cystic medial necrosis in a non-Marfan patient. Ann Thorac Surg, 2007, 83(2):668-670.
13. Aqel RA, Zoghbi GJ, Iskandrian A. Spontaneous coronary artery dissection, aneurysms, and pseudoaneurysms:a review. Echocardio-graphy, 2004, 21(2):175-182.
14. Cafri C, Gilutz H, Kobal S, et al. Rapid evolution from coronary dissection to pseudoaneurysm after stent implantation:a glimpse at the pathogenesis using intravascular ultrasound. Invasive Cardiol, 2002, 14(5):286-289.
15. Aoki J, Kirtane A, Leon MB, et al. Coronary artery aneurysms after drug-eluting stent implantation. JACC Cardiovasc Interv, 2008, 1(1):14-21.
16. Garrand TJ, Mintz GS, Popma JJ, et al. Intravascular ultrasound diagnosis of a coronary artery pseudoaneurysm following percutan-eous transluminal coronary angioplasty. Am Heart J, 1993, 125(3):880-882.
17. Pahlavan PS, Niroomand F. Coronary artery aneurysm:a review. Clin Cardiol, 2006, 29(10):439-443.
18. Vranckx P, Pirot L, Benit E. Giant left main coronary artery aneurysm in association with severe atherosclerotic coronary disease. Cathet Cardiovasc Diagn, 1997, 42(1):54-57.
19. Ling Y, Ruan W, Tang M, et al. Giant aneurysm in coronary right ventricular fistula associated with severe tricuspid insufficiency in an adult. Eur Heart, 2016, 22(1):40.
20. Lazar JF, Compton M, Li F, et al. Excising a giant:report of a 7 cm coronary artery aneurysm. Tex Heart Inst J, 2013, 40(2):173-175.
21. Jha NK, Ouda HZ, Khan JA, et al. Giant right coronary artery aneurysm-case report and literature review. Cardiothorac Surg, 2009, 4:18.
22. Zoneraich S, Zoneraich O, Rhee JJ, et al. Giant coronary artery aneurysm. The cause of middiastolic murmur and bulging of the left cardiac border. JAMA, 1975, 231(2):179.
23. Morita H, Ozawa H, Yamazaki S, et al. A case of giant coronary artery aneurysm with fistulous connection to the pulmonary artery:a case report and review of the literature. Intern Med, 2012, 51(11):1361-1366.
24. Mata KM, Fernandes CR, Floriano EM, et al. Novel strategies in ischemic heart disease. Intech, 2012, 381-404.
25. Nazareth J, Weinberg L, Fernandes J, et al. Giant right coronary artery aneurysm presenting with non-ST elevation myocardial infarction and severe mitral regurgitation:a case report. Med Case Rep, 2011, 5:442.
26. Kelley MP, Carver JR. Coronary artery aneurysms. Invasive Cardiol, 2002, 14(8):461-462.
27. Maehara A, Mintz GS, Ahmed JM, et al. An intravascular ultrasound classification of angiographic coronary artery aneurysms. Am Cardiol, 2001, 88(4):365-370.
28. Ge J, Liu F, Gorge G, et al. Intravascular ultrasound approach to the diagnosis of coronary artery aneurysms. Am Heart, 1995, 130(4):765-771.
29. Szalat A, Durst R, Cohen A, et al. Use of polytetrafluoroethylene-covered stent for treatment of coronary artery aneurysm. Catheter Cardiovasc Interv, 2005, 66(2):203-208.
30. Izutani H, Shibukawa T, Kawamoto J, et al. Spontaneous right coronary artery pseudoaneurysm. Gen Thorac Cardiovasc Surg, 2007, 55(6):259-261.
31. Pavlidis AN, Malakos JS, Karavolias GK, et al. Left main coronary artery aneurysm. Herz, 2012, 37(5):565-566.
32. Chrissoheris MP, Donohue TJ, Young RS, et al. Coronary artery aneurysms. Cardiol Rev, 2008, 16(3):116-123.
33. Banerjee P, Houghton T, Walters M, et al. Giant right coronary artery aneurysm presenting as a mediastinal mass. Heart, 2004, 90(9):50.
34. Olson JP, Chamusco RF. Giant left main coronary artery aneurysm initially seen as an acute coronary syndrome. Am Heart J, 1995, 129(6):1216-1217.
35. Daoud AS, Pankin D, Tulgan H, et al. Aneurysms of the coronary artery. Report of ten cases and review of literature. Am J Cardiol, 1963, 11:228-237.
36. Newcomb EW, Youngman DJ, Burton NA, et al. Atherosclerotic aneurysm of the left main coronary artery. Am Coll Cardiol, 1984, 4(5):1062-1064.
37. Zeb M, McKenzie DB, Scott PA, et al. Treatment of coronary aneur-ysms with covered stents:a review with illustrated case. Invasive Cardiol, 2012, 24(9):465-469.
38. Bhindi R, Testa L, Ormerod OJ, et al. Rapidly evolving giant coronary aneurysm. Am Coll Cardiol, 2009, 53(4):372.
39. Pradhan A, sharma AK, Jain N, et al. Giant coronary arterial aneur-ysm after drug-eluting stent implantation. Case Rep, 2016, 5(4):214488.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Review on Diagnosis and Treatment of Giant Coronary Artery Aneurysm

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