(Circulation. 2000;101:e202.)
© 2000 American Heart Association, Inc.
Circulation Electronic Pages |
Three-Dimensional Densimetric Analysis of Coronary Artery Aneurysm
From the Department of Cardiothoracic Surgery, National Heart and Lung Institute, Imperial College of Science, Technology, and Medicine, Hammersmith Hospital, London, UK.
Correspondence to Dr Michael Poullis, Cardiothoracic Research Fellow, Department of Cardiothoracic Surgery, Hammersmith Hospital, Du Cane Rd, E Acton, London, W12 0NN, UK. E-mail mpoullis@rpms.ac.uk
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Introduction |
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A 43-year-old man, previously fit and well, was admitted with an anterior myocardial infarct treated with recombinant tissue plasminogen activator. Five days later, he underwent coronary angiography, which demonstrated a proximal aneurysm of the left anterior descending coronary artery (LAD) (Figure 1
), with a severe stenosis
immediately distal to the aneurysm (Figure 2) and right coronary artery
disease (Figure 3).
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The presence of a clot or atherosclerotic plaque in the
aneurysm sac, which might be disrupted and cause distal
embolization with occlusion of the LAD at the site of the
stenosis, could be excluded via quantitative 3D angiography of
the aneurysm sac. Figure 4 shows
the saccular/eccentric nature of the aneurysm sac, and Figure 5 demonstrates the absence of a clot or
atherosclerotic plaque within the aneurysm. Figure 6 demonstrates a 3D reconstruction of the
disease in the right coronary artery. Unfortunately, attempted
angioplasty of the stenosis resulted in the coiling of the
guidewire in the aneurysm sac (Figure 7). The patient was referred for
coronary artery surgery. He made an uneventful recovery and was
discharged 6 days later.
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