Reconstruction of a left main coronary artery aneurysm using a radial artery patch

TL;DR

A rare case of a left main coronary artery aneurysm was successfully repaired using a radial artery patch in a 70-year-old woman.

Contribution

This case highlights the use of radial artery patch for aneurysm reconstruction as an alternative to bypass grafting.

Findings

Surgical repair using a radial artery patch was successful without the need for coronary bypasses.

Reconstruction may be preferable to ligation and bypass grafting when anatomy is suitable.

Preserving native coronary circulation can reduce long-term graft dependency.

Abstract

A left main coronary artery aneurysm is a rare anomaly. There are no standardized treatment guidelines given the infrequency of reported cases. A 70-year-old African American female with an enlarging distal left main coronary artery aneurysm was taken to the operating room for surgical intervention. The patient underwent a successful open surgical repair of the aneurysm with reconstruction of the distal left main using a radial artery patch. No coronary bypasses were necessary. Aneurysm ligation with concomitant coronary artery bypass grafting is commonly reported but reconstruction may be preferable when the anatomy is suitable. Preservation of nonobstructed native coronary artery circulation should also be considered to avoid life-long graft dependency.

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