|Year : 2023 | Volume
| Issue : 2 | Page : 196-197
Surgical Revascularization of an Unusual Long Length Rosary Bead-like Coronary Artery Aneurysm: A Surgical Delight
Sarvesh Kumar, Kumar Rahul, Mohammad Zeeshan Hakim, Vivek Tewarson, Bhupendra Kumar, Shobhit Kumar, Sushil K Singh
Department of Cardiovascular and Thoracic Surgery, King George's Medical University, Lucknow, Uttar Pradesh, India
|Date of Submission||09-May-2023|
|Date of Acceptance||17-Jun-2023|
|Date of Web Publication||30-Aug-2023|
Sushil K Singh
Department of Cardiovascular and Thoracic Surgery, King George's Medical University, Shahmina Road, Lucknow - 226 003, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Kumar S, Rahul K, Hakim MZ, Tewarson V, Kumar B, Kumar S, Singh SK. Surgical Revascularization of an Unusual Long Length Rosary Bead-like Coronary Artery Aneurysm: A Surgical Delight. J Indian Acad Echocardiogr Cardiovasc Imaging 2023;7:196-7
|How to cite this URL:|
Kumar S, Rahul K, Hakim MZ, Tewarson V, Kumar B, Kumar S, Singh SK. Surgical Revascularization of an Unusual Long Length Rosary Bead-like Coronary Artery Aneurysm: A Surgical Delight. J Indian Acad Echocardiogr Cardiovasc Imaging [serial online] 2023 [cited 2023 Sep 27];7:196-7. Available from: https://jiaecho.org/text.asp?2023/7/2/196/384772
A 52-year-old male patient was admitted to the cardiology emergency department with sudden-onset chest pain and non-ST-segment elevation myocardial infarction. He was planned for coronary angiography. His past medical history was not suggestive of coronary artery disease; however, he had a history of smoking, type 2 diabetes mellitus, and essential hypertension. There was no history of any inflammatory disease, allergy, or autoimmune disorder. He had no significant family history of coronary artery disease or any other comorbid conditions. Routine blood investigations including lipid profile were within the normal limits. Transthoracic echocardiography revealed an ejection fraction of 55% with normal cardiac chamber dimensions and valvular function. Subsequently, he underwent coronary angiography which demonstrated occlusive disease in the left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA) along with an unusual rosary bead-like coronary artery appearance, suggesting multiple fusiform aneurysmal dilatations [Figure 1]a and [Figure 1]b. He was diagnosed with multiple fusiform aneurysmal dilatations with occlusive coronary artery disease and was planned for coronary artery bypass grafting (CABG). Informed and written consent was obtained and an elective multi-vessel CABG was performed. Three grafts were put for revascularization of LAD, LCx and RCA (left internal mammary artery to LAD; reverse saphenous vein grafts to obtuse marginal and distal RCA). The intraoperative course was uneventful with stable vitals and minimal inotropic support. The patient was shifted to the intensive care unit postoperatively with stable hemodynamic parameters. He was discharged on the postoperative day 8 and has been in follow-up and doing well. In conclusion, coronary artery ectasias and aneurysms are extremely rare with an unknown origin. The management strategy primarily depends on the type and location of the lesion as well as hemodynamic status of the patient and comorbidities. With multiple long segment fusiform aneurysmal dilatations with occlusive coronary artery disease, surgical revascularization is the treatment of choice. The results after surgical therapy are excellent. Accordingly, this patient was successfully treated with surgical revascularization of coronary stenoses. This cases is presented here due to its rare occurrence in the clinical practice and the striking coronary anatomy.
|Figure 1: (a) Coronary angiography showing an unusual rosary bead-like coronary artery appearance with multiple fusiform aneurysmal dilatations in the left anterior descending artery and left circumflex artery. (b) An unusual rosary bead-like appearance of the right coronary artery with multiple fusiform aneurysmal dilatations|
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Informed consent was obtained from the patient and his family regarding publishing their data and photographs.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
Coşkun E. Surgical revascularization of a rosary bead-like coronary artery aneurysm: Case report. Clin Surg 2017;2:1792.
Singh SK, Goyal T, Sethi R, Chandra S, Devenraj V, Rajput NK, et al.
Surgical treatment for coronary artery aneurysm: A single-centre experience. Interact Cardiovasc Thorac Surg 2013;17:632-6.