A giant coronary artery aneurysm burrowing into left ventricular cavity following drug eluting stent implantation: A case report
Ajeya N Ukadgaonkar and Dr. Suhas Hardas
Poona Hospital and Research Centre, India
: Int J Cardiovas Res
Abstract
Coronary artery aneurysms are rarely seen with an overall incidence of 1.5 to 5% and post coronary intervention incidence is 0.2 to 1.7%. They are reported to be more common after a drug eluting stent (DES) rather than a bare metal stent (BMS). Post stent coronary artery aneurysm formation is a dreaded complication which can lead to sudden death. We report a case of a 53 years old diabetic and hypertensive male who underwent percutaneous transluminal coronary angioplasty (PTCA) to the left anterior descending artery (LAD) with everolimus eluting stent (EES). Two months later he presented with angina, heart failure and severe left ventricular dysfunction. His check coronary angiography revealed a giant (30 x 20 mm) type 2 coronary artery aneurysm arising from LAD with occluded stent distal to the aneurysm. He was posted for surgery, during which the aneurysm was found to be communicating directly to the left ventricular cavity. Surgical aneurysmectomy with coronary artery bypass graft to LAD was done. Post operatively, the patient recovered rapidly and was discharged. To the best of our knowledge, acquired (post PTCA) giant coronary artery aneurysm communicating to the left ventricular cavity has hardly been reported yet. Due to paucity of these types of cases we have a limited experience in diagnosis and management of these patients. This case report will serve as an informative tool for diagnosis and management of these rare presentations of the heterogeneous disease. Prompt identification and treatment is the key for management of this fatal complication.
Biography
Ajeya N Ukadgaonkar is pursuing a superspeciality course (DNB) in Cardiology in Poona Hospital and Research Centre, India. He has completed his MD in Internal Medicine and has worked As an Assistant professor in Internal Medicine. He has 2 publications in international and 1 publication in a national journal to his name. He bears a special interest in the field of research.
