Massive aneurysm of the left main coronary artery

We report the unusual case of a 59-year-old patient who presented with ST elevation myocardial infarction associated with a left main coronary artery aneurysm. The patient was managed without intervention due to late presentation. At latter follow up, the patient did not agree with surgical intervention and remained asymptomatic on medical therapy after 2 years of follow up. Although no obvious cause for the aneurysm was found, a previous thoracic trauma was the most probable etiological cause.

We present a rare case of a patient diagnosed with aortic insufficiency grade III and a giant coronary artery aneurysm with a maximum diameter of 12 cm. Surgical intervention revealed an incompetent bicuspid aortic valve and a huge thrombosed aneurysm, which communicated with the aorta through the left coronary ostium. In addition to direct closure of the ostium, a saphenous vein was anastomosed to the left anterior descending artery, and the aortic valve was successfully replaced with a mechanical valve.

Left main coronary artery aneurysms are rare, and treatment options are poorly defined. Here we report the surgical management of a female patient who presented with an acute coronary syndrome resulting from dissection of an aneurysmal left main. She was successfully managed with an interposition graft fashioned from the lateral femoral circumflex artery.

Coronary artery aneurysms are rare, especially in the left main coronary artery. Coronary artery aneurysms may rupture or cause myocardial infarction. There are only a few reports of coronary artery aneurysms of the left main coronary artery treated surgically. We report a case in which an arterial graft from the internal iliac (hypogastric) artery was used for the reconstruction of a congenital coronary artery aneurysm of the left main coronary artery. After a follow-up of 5 years, the patient is well and in good condition.