The patient was a 71-year-old man who had a known circumflex artery aneurysm and coronary artery bypass surgery in 1982. The aneurysm was left intact because of difficulty in surgical removal at that time. Recently, because of symptoms of angina pectoris, he underwent coronary arteriography, which demonstrated occlusion of saphenous venous grafts and patency of the left internal thoracic arterial graft.
The patient then had an aortocoronary bypass and mitral valve replacement (for mitral regurgitation) at our institution. At surgery, the circumflex artery aneurysm was found to measure 6×8 cm in the superior aspect of the atrioventricular grove. This aneurysm was not excised because of technical difficulty.
This case illustrates the appearance of an arterial aneurysm by multiple modalities: transesophageal echocardiography, magnetic resonance imaging, selective coronary angiography, and direct visualization.
- Copyright © 1995 by American Heart Association