Giant aneurysm of the right coronary artery and magnetic resonance coronary angiography

Coronary artery aneurysm (CAA) is generally defined as coronary dilatation that exceeds the diameter of normal adjacent segments or the diameter of the patient’s largest coronary vessel by 1.5 times. The prime cause of CAAs is atherosclerosis, and the most commonly affected artery is the right coronary artery. CAAs are quite commonly detected during X-ray coronary angiography. However, Coronary artery aneurysm (CAA) is generally defined as coronary dilatation that exceeds the diameter of normal adjacent segments or the diameter of the patient’s largest coronary vessel by 1.5 times. The prime cause of CAAs is atherosclerosis, and the most commonly affected artery is the right coronary artery. CAAs are quite commonly detected during X-ray coronary angiography. However, giant CAAs, especially with the diameter exceeding 100 mm, are extremely rare. The treatment method of choice of giant CAAs is the excision of aneurysm with coronary artery bypass grafting. We present a case of a 41-year-old apparently healthy woman with a giant right CAA. This was detected by noninvasive methods, including magnetic resonance coronary angiography, and its maximum diameter exceeded 100 mm. In emergency, the aneurysmal sac was excised and the aortocoronary saphenous vein graft was performed. We also present a review of the published studies of giant CAAs with the diameter exceeding 100 mm.