Double giant coronary aneurysm: improved morphological study by computed tomography

Abstract

Coronary artery aneurysm may cause coronary artery rupture, thromboembolism or haemodynamic problems related to compression. We report the case of a 68-year old man who was referred to an intensive cardiological care unit for recurrence of ventricular tachycardia. Coronary angiography revealed two large aneurysms of the mid-right coronary artery. A multislice computed tomography (CT) study demonstrated marked underestimation by invasive angiography because of the large thrombus. The patient was referred for cardiac surgery. The right mammary artery was used as a bypass graft to the distal segment of the right coronary artery and the two aneurysms were ligated proximally and distally after removal of their thrombus filling. The postoperative CT confirmed patency of the bypass graft and the vascular exclusion of the aneurysm, with no opacification. Cardiac CT is a promising tool for the comprehensive study of coronary aneurysms, both before and after surgery.