Giant left main coronary artery aneurysm: Our experience of rare case

Introduction. Coronary artery aneurysms are rare disorders, especially left main coronary artery aneurysm. In literature there are number of reported cases with coronary artery aneurysms, various localization, size, clinical presentation and way of treatment. There is no unique consensus about the most adequate treatment in these patients; surgery is still preferable, although there are some new experiences of percutaneous treatment. The decision is made for each patient individually. We report a case of giant left main coronary artery aneurysm, with acute coronary syndrome and heart failure presentation, surgically treated. Case report. A 66-year-old female patient was admitted to the Emergency Department of our Clinic due to chest pain and dyspnea. Acute non-STEMI myocardial infarction of anterolateral localization was diagnosed (CK max 1,111, troponin T 3.754) complicated with acute heart failure. Heart catheterization and coronary angiography revealed a giant saccular, 3.5 x 3.5 mm left main coronary artery aneurysm full with thrombi, compressing the proximal segments of left anterior descending (LAD) and circumflex artery (Cx). Conclusion. Giant left main coronary artery aneurysms are rare pathologic finding and there are no established principles for treatment. Although, percutaneous way of treatment is now available in selected cases, surgical approach is still preferred for these patients.