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Ajeya N Ukadgaonkar

Ajeya N Ukadgaonkar

Poona Hospital and Research Centre, India

Title: A giant coronary artery aneurysm burrowing into left ventricular cavity following drug eluting stent implantation: A case report

Biography

Biography: Ajeya N Ukadgaonkar

Abstract

Coronary artery aneurysms are rarely seen with an overall incidence of 1.5 to 5% and post coronary intervention incidence is 0.2 to 1.7%. They are reported to be more common after a drug eluting stent (DES) rather than a bare metal stent (BMS). Post stent coronary artery aneurysm formation is a dreaded complication which can lead to sudden death. We report a case of a 53 years old diabetic and hypertensive male who underwent percutaneous transluminal coronary angioplasty (PTCA) to the left anterior descending artery (LAD) with everolimus eluting stent (EES). Two months later he presented with angina, heart failure and severe left ventricular dysfunction. His check coronary angiography revealed a giant (30 x 20 mm) type 2 coronary artery aneurysm arising from LAD with occluded stent distal to the aneurysm. He was posted for surgery, during which the aneurysm was found to be communicating directly to the left ventricular cavity. Surgical aneurysmectomy with coronary artery bypass graft to LAD was done. Post operatively, the patient recovered rapidly and was discharged. To the best of our knowledge, acquired (post PTCA) giant coronary artery aneurysm communicating to the left ventricular cavity has hardly been reported yet. Due to paucity of these types of cases we have a limited experience in diagnosis and management of these patients. This case report will serve as an informative tool for diagnosis and management of these rare presentations of the heterogeneous disease. Prompt identification and treatment is the key for management of this fatal complication.

 

Recent Publications

1. Gadepalli R et al (2017) A case of early development of giant coronary artery aneurysms after drug-eluting stents implantation: An unpredictable menace. Interventional Medicine & Applied Science, Vol. 9 (1), pp. 47–50.

2. Kar et al (2016) Post Balloon Stent Right Coronary Artery Aneurysm: Cardiologist’s Nightmare. J Cardiovasc Dis Diagn 2016, S1.

3. Bhupali et al (2015) Giant Coronary Artery Pseudoaneurysm  after Drug-Eluting Stent Implantation. International Journal of Clinical Medicine, 2015, 6, 554-560.

4.  Mishra et al (2014) Multiple Giant Coronary Arterial Aneurysms following Sirolimus Drug Eluting Stents Implantation. Journal of the association of physicians of india  vol 62  october, 2014.

5. Crawley PD, Mahlow WJ, Huntsinger DR, Afiniwala S, Wortham DC (2014) : Giant coronary artery aneurysms: Review and update. Tex Heart Inst J 41, 603–608.

6. Kadakia MB, EppsKC, JulienME, OgbaraJ, Giri J, KolanskyDM, Woo YJ, Wilensky RL (2014) : Early aneurysm formation after everolimus eluting stent implantation. Circ Cardiovasc Interv 7, 266–267.

7. Bennett J, Dubois C (2013) : A novel platinum chromium everolimus eluting stent for the treatment of coronary artery disease. Biologics 7, 149–159.

8. Marla R, Ebel R, Crosby M, Almassi GH (2009): Multiple giant coronary artery aneurysms. Tex Heart Inst J 36, 244.

9. Pahlavan PS, Niroomand F (2006) : Coronary artery aneurysm: A review. Clin Cardiol 29, 439–443