Coronary artery aneurysms (CAA) may exceed 5 cm, commonly involve the right coronary artery (RCA), may occur in close proximity to the left main trunk, and may result in pulmonary artery fistulae or compress the right atrium and present as a pericardial mass. We present images of a CAA of the RCA with a fistula to the left ventricle (LV).A 64‐year‐old female was evaluated for palpitations and found on computed tomography (CT) scan to have a 6‐cm right CAA (RCAA) with a fistula to the posterior LV (Figures A and B). At the time of surgery, cardiopulmonary bypass was instituted by aortic and bicaval cannulation. The aorta was crossclamped and the heart arrested with retrograde cold blood cardioplegia. The RCCA was opened, the fresh clot removed, and the orifices of the branches were suture ligated (Figures A and B). The RCCA fisutula was closed with a pericardial patch and the ostium of the RCA was closed with a Dacron patch (Figure C). An end‐side anastomosis was performed to the posteriolateral branch using a segment of saphenous vein, followed by a side‐side anastomosis to the posterior descending artery, and a proximal anastomosis to the ascending aorta (Figure D). The patient tolerated
Journal of Cardiac Surgery – Wiley
Published: Jan 1, 2018
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