Author/Authors :
Janjua, Jamal Department of Internal Medicine - Gundersen Health System, La Crosse, WI, USA , Odigie-Okon, Esosa G. Department of Cardiology - Gundersen Health System, La Crosse, WI, USA , Rabindranauth, Premnauth Department of Cardiothoracic Surgery - Gundersen Health System, La Crosse, WI, USA , Wittchow, Richard J. Department of Pathology - Gundersen Health System, La Crosse, WI, USA , Riaz, Aiman Department of Internal Medicine - Gundersen Health System, La Crosse, WI, USA
Abstract :
Giant coronary artery aneurysms (CAAs) are defined as having a diameter of greater than 2 cm. We report a case of an 82-year-old
male with severe aortic stenosis incidentally diagnosed with giant right coronary artery aneurysm (gRCAA) while undergoing
evaluation for transcather aortic valve replacement (TAVR). It was causing a mass effect on the right cardiac chambers but was
otherwise asymptomatic. Our patient was successfully treated with surgical excision of aneurysm with concomitant coronary
artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR). The patient remained stable at discharge and on
serial follow-ups for two years. In conclusion, due to the associated complication and increased risk of mortality with giant
coronary aneurysms, we recommend surgical approach instead of medical management alone. We also call for evidence-based
recommendations and guidelines for management of TAVR incidentalomas.
Keywords :
Valve Replacement , Incidentalomas , Coronary Aneurysm , Transcatheter Aortic
