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Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report

BACKGROUND: The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instabili...

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Autores principales: Shen, Jiayu, Zhou, Yang, Fang, Zhi, Hu, Jia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612139/
https://www.ncbi.nlm.nih.gov/pubmed/31277612
http://dx.doi.org/10.1186/s12893-019-0547-z
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author Shen, Jiayu
Zhou, Yang
Fang, Zhi
Hu, Jia
author_facet Shen, Jiayu
Zhou, Yang
Fang, Zhi
Hu, Jia
author_sort Shen, Jiayu
collection PubMed
description BACKGROUND: The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instability who was diagnosed with multiple giant CAAs combined with RCA-PA fistula. CASE PRESENTATION: The patient, a 60-year-old female, presented to the emergency room because of progressive exertional chest distress and fatigue. The transthoracic echocardiography (TTE), coronary computed tomography angiography (CTA) and invasive coronary angiography confirmed the existence of multiple giant CAAs and RCA-PA fistula. Laboratory examinations for systemic vasculitis and infectious diseases demonstrated no abnormalities and work-up for childhood and family history were negative. We have performed a successful surgical treatment for this patient. The patient’s restrictive cardiac dysfunction was improved after debriding the advanced thrombi in aneurysm sac and ligating the fistulous vessel between the native RCA and PA. The postoperative pathologic examination of the aneurysmal wall revealed loss of smooth muscle cells in the media with local mucoid degeneration, no chronic inflammation, sclerosis and IgG4 were observed. CONCLUSIONS: The treatment decision-making process should depend upon the patients’ specific situations. Our case suggests the surgical intervention should be accepted as the preferred treatment for giant CAAs with restrictive cardiac dysfunction. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12893-019-0547-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-66121392019-07-16 Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report Shen, Jiayu Zhou, Yang Fang, Zhi Hu, Jia BMC Surg Case Report BACKGROUND: The combination of multiple giant coronary artery aneurysms (CAAs) and right coronary artery (RCA) to pulmonary artery (PA) fistula is extremely rare and the patients with CAAs may suffer from several fatal complications. We herein describe a 60-year-old female with hemodynamic instability who was diagnosed with multiple giant CAAs combined with RCA-PA fistula. CASE PRESENTATION: The patient, a 60-year-old female, presented to the emergency room because of progressive exertional chest distress and fatigue. The transthoracic echocardiography (TTE), coronary computed tomography angiography (CTA) and invasive coronary angiography confirmed the existence of multiple giant CAAs and RCA-PA fistula. Laboratory examinations for systemic vasculitis and infectious diseases demonstrated no abnormalities and work-up for childhood and family history were negative. We have performed a successful surgical treatment for this patient. The patient’s restrictive cardiac dysfunction was improved after debriding the advanced thrombi in aneurysm sac and ligating the fistulous vessel between the native RCA and PA. The postoperative pathologic examination of the aneurysmal wall revealed loss of smooth muscle cells in the media with local mucoid degeneration, no chronic inflammation, sclerosis and IgG4 were observed. CONCLUSIONS: The treatment decision-making process should depend upon the patients’ specific situations. Our case suggests the surgical intervention should be accepted as the preferred treatment for giant CAAs with restrictive cardiac dysfunction. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12893-019-0547-z) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-05 /pmc/articles/PMC6612139/ /pubmed/31277612 http://dx.doi.org/10.1186/s12893-019-0547-z Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Shen, Jiayu
Zhou, Yang
Fang, Zhi
Hu, Jia
Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title_full Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title_fullStr Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title_full_unstemmed Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title_short Multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
title_sort multiple giant coronary artery aneurysms combined with right coronary artery-pulmonary artery fistula: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6612139/
https://www.ncbi.nlm.nih.gov/pubmed/31277612
http://dx.doi.org/10.1186/s12893-019-0547-z
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