Distal Left Main Coronary Artery Aneurysm Resection during 5-Vessel Coronary Artery Bypass Grafting

Abstract

Coronary artery aneurysms are abnormal dilations of arterial segments, in some cases associated with underlying atherosclerosis. Although affected patients can be asymptomatic, some are at risk of plaque rupture, dissection, and other complications. Investigations into the optimal management of these vascular malformations are ongoing, because no consensus exists regarding when and how best to intervene. We present the case of a 58-year-old man whose large left main coronary artery aneurysm we ligated and removed during 5-vessel coronary artery bypass grafting. This distal aneurysm was at the trifurcation level of the patient's left anterior descending and left circumflex coronary arteries. In addition, we discuss considerations about left main coronary artery aneurysms and their treatment.