Singular Coronary Artery Aneurysm
Imaging With Coronary Angiography Versus 16-Slice Computed Tomography, Transesophageal Echocardiography, and Magnetic Resonance Tomography
A 79-year-old man with an intermittent second-degree atrioventricular block and an incomplete right bundle-branch block was referred to our facility to be evaluated for coronary artery disease before he underwent noncardiac surgery. Coronary angiography (Figure 1) showed a singular aneurysm of the left coronary artery with a diameter of 15 mm. The aneurysm originated from the distal left main stem in the angle between the origin of the left descending and the circumflex arteries. Only minor coronary plaques were identified; therefore, coronary artery disease could be excluded. The aneurysm also was examined with a 16-slice CT scanner (Aquilion, Toshiba Medical Systems) with intravenous bolus injection of iopromide and 3D reconstruction (Figure 2), multiplane transesophageal echocardiography (Vivid 7, General Electric Medical Systems; Figure 3), and magnetic resonance tomography (MAGNETOM Sonata, Siemens; Figure 4). The 3 different cardiac imaging modalities confirmed the findings of the coronary angiography. Because no stenoses of the vessels were involved, noncardiac surgery was performed without problems.