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

Operative Strategy for Coronary Aneurysms

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.