Operative Decision-Making in Coronary Artery Aneurysms: A Case Series: Operative Strategy for Coronary Aneurysms

Toheed Fatima Ali; Ali Gheissari

doi:10.28982/josam.8515

Authors

Toheed Fatima Ali Graduate Medical Education, Mercy Health – St. Rita’s Medical Center, Lima, Ohio, Usa https://orcid.org/0009-0005-9092-7743
Ali Gheissari St George University School of Medicine https://orcid.org/0009-0003-7400-475X

DOI:

https://doi.org/10.28982/josam.8515

Keywords:

Right coronary artery aneurysm, Off-pump coronary artery bypass, Abdominal aortic aneurysm, Surgical ligation, Case series, Coronary artery aneurysm, Coronary artery aneurysm management, Aneurysm ligation, Saphenous vein graft, Aneurysmal vascular disease, Postoperative surveillance

Abstract

Coronary artery aneurysms (CAA) are uncommon, and management recommendations remain limited due to variability in underlying etiology and clinical presentation. We report two cases of right coronary artery aneurysm (RCAA) managed surgically within two months. The first patient was a 69-year-old male with RCAA and obstructive coronary artery disease who underwent off-pump coronary artery bypass using a saphenous vein graft to the right coronary artery with aneurysm ligation. The second patient was a 68-year-old male with two large thrombotic RCAA and a concurrent abdominal aortic aneurysm, raising concern for broader vascular involvement. He underwent off-pump coronary artery bypass using saphenous vein grafts to the right ventricular, posterior descending, and posterolateral branches, along with aneurysm ligation. These cases emphasize the need for an individualized, anatomy-driven framework for CAA repair and long-term surveillance, offering a practical reference point for future operative planning.

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