Clinical features and treatment of coronary artery aneurysms

Objective To investigate the clinical characteristics and therapeutic methods of coronary artery aneurysm (CAA). Methods The clinical data and coronary angiography of 32 patients confirmed by coronary angiography as coronary aneurysm in Shenzhen Hospital of Southern Medical University and Shenzhen People′s Hospital were collected. They were followed up, and the different therapeutic methods were analyzed. Results Thirty-two cases (1.8%) of coronary artery aneurysms were found in 1 778 patients undergoing coronary angiography. The main sites of coronary ectasia were right coronary artery, anterior descending branch and circumflex branch, and the left main branch was rare. Among the patients with coronary artery aneurysms, there were 25 patients with coronary artery stenosis. All the 32 patients were given anticoagulant, antiplatelet, improvement of coronary spasm and statin therapy, among whom 2 patients were treated with stent implantation and 6 patients were treated with coronary artery bypass graft (CABG) and ligation of coronary aneurysm. During the follow-up (average 15 months) of 1 patient, acute myocardial infarction reoccurred, and coronary angiography indicated that the stenosed coronary segments after artery ectasia was occluded because of thromboembolism. In the remaining patients, there were no major cardiovascular events such as angina pectoris, acute myocardial infarction and sudden cardiac death. Conclusions Coronary artery aneurysm is not a rare heart disease. Coronary thromboembolism, thrombosis and vasospasm are the main causes of angina pectoris and myocardial infarction. Anticoagulant, antiplatelet, antispasmodic drugs and suitable coronary artery bypass can significantly improve the clinical prognosis of patients with coronary artery aneurysm. Key words: Coronary artery aneurysm; Thrombosis; Anticoagulant therapy; Coronary artery bypass graft