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19.02.2021 | Original Article Open Access

Surgical exclusion of an idiopathic saccular aneurysm in the left main trunk of the coronary artery

Zeitschrift:
Surgery Today
Autoren:
Naoki Tadokoro, Satsuki Fukushima, Yusuke Shimahara, Tetsuya Saito, Naonori Kawamoto, Hideyuki Shimizu, Tomoyuki Fujita
Wichtige Hinweise

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Abstract

Purpose

A coronary artery aneurysm (CAA) can result in critical cardiac events such as thromboembolic complications or rupture. A saccular CAA located in the left main trunk (LMT) is the most critical form of this pathology and its surgical repair is challenging. We conducted this single-center study to review the surgical outcomes of patients with a saccular CAA in the LMT.

Methods

Between May, 2012 and June, 2020, five patients with a saccular CAA in the LMT underwent surgery at our center. The median age at operation was 66.5 (59.7–69) years and the median diameter of the CAA was 13.0 mm (IQR 11–14 mm).

Results

The CAA was fully excluded by patch closure of the LMT orifice and direct closure of the distal LMT, supplemented by coronary artery bypass grafting with the exclusive use of arterial conduits. There was no in-hospital mortality, although one patient suffered graft spasm-related myocardial infarction with complete recovery. Post-operative angiography showed a fully excluded LMT in all patients. There was no mortality or adverse cardiac events during follow-up.

Conclusions

Our surgical policy for CAA in the LMT is feasible and safe; however, coronary blood flow is dependent on reliable bypasses.

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