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Giant coronary aneurysm in the septal branch
  1. M Motooka,
  2. T Konishi,
  3. Y Himura

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An asymptomatic 61 year old woman was referred to our institution because of diastolic murmur. She had no illness comparable to Kawasaki disease. An abnormal cavity in the interventricular septum with the jet flowing from the left anterior descending coronary artery into the cavity was detected by Doppler echocardiography. Coronary angiography showed a 25 × 15 mm aneurysm in the septal branch of the left anterior descending artery (panel A). Multislice computed tomography showed that the minimal distance between the left ventricular cavity and the aneurysmal cavity was only 1 mm (panel B). Considering that the pressure on both sides of the aneurysmal wall must be almost the same, we have not performed surgery or catheter intervention and have placed the patient under close observation.

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Left coronary angiogram. Right anterior oblique projection with caudal angulation. A giant aneurysm and dilatation of the proximal portion of the left anterior descending coronary artery are seen. The aneurysm communicates only with the septal branch and has no draining vessels. There are some protrusions on the surface of the aneurysm.

Embedded Image

The axial image of multislice computed tomography of the patient. Note that the cavity of the aneurysm (asterisk) is separated from the left ventricle (LV) by a very thin wall with only 1 mm thickness. RV, the right ventricle.

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