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European Heart Journal Advance Access originally published online on March 16, 2007
European Heart Journal 2007 28(17):2063; doi:10.1093/eurheartj/ehm002
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

The heart of coronary arteries

Marco Valgimigli1,2,* and Patrizia Malagutti1,2

1 Institute of Cardiology, University of Ferrara, C.rso Giovecca 203, 44100 Ferrara, Italy
2 Cardiovascular Research Centre, Salvatore Maugeri Foundation, IRCCS Gussago (BS), Italy

* Corresponding author. Tel: +39 0532 202143; fax: +39 0532 241885. E-mail address: vlgmrc{at}unife.it

A 67-year-old man with a medical history notable for treated type II diabetes, dyslipidaemia and hypertension, was admitted to the hospital for repeated episodes of angina with mild effort or at rest. A coronary angiogram showed lumen stenosis in the mid-tract of the right coronary artery and in the first obtuse marginal branch (Panel A). In the proximal tract of left anterior descending artery, a severe stenosis (Panel A, arrow) was also observed, followed by giant heart-shaped coronary artery aneurysm (CAA) (Panel B, magnified in the insert). The patient underwent coronary artery bypass grafting of the three main coronary vessels. The 1-year follow-up was uneventful.

CAA, defined as a localized dilatation of the coronary artery with a diameter ≥ 1.5 times that of an adjacent coronary segment, has been observed in 0.2–5.3% of patients undergoing coronary angiography. CAA most often involves the right coronary artery followed in frequency by the left anterior descending. Most CAAs are atherosclerotic in origin, although other aetiologies include congenital aneurysms, Kawasaki syndrome, infectious arteritis, and coronary trauma, including that related to percutaneous coronary intervention.

The catheter-based treatment of coronary aneurysm through polytetrafluoroethylene-covered stent implantation or core embolization is feasible in selected cases. The safety and efficacy of the percutaneous approach in comparison with conventional surgical treatment remain to be established.

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This Article
Right arrow FREE Full Text (PDF) Freely available
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28/17/2063    most recent
ehm002v1
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