501
Atherosclerotic Left
Large
CoronaryAneurysm
Main
A
Case
and Reviewofthe Literature
Report
E.
Mahendra
Guillermo
and James
MD,
Khanal,
Mandawat, MD,
Pineda, MD,
Sanjaya
GA
Wilkin, MD,
Augusta,
is
a
an
dilatation of
coronary
rare
characterized
abnormal
(CAA)
disorder,
artery aneurysm
by
Coronary
a
localized
of the
It is
portion
coronary artery.
coronary artery aneurysms
is not well understood. Their
usually diagnosed incidentally by
of
are of
The natural
considered
disease
Over 50%
atherosclerotic
origin.
angiography.
of
is not
history
to be an
coronary aneurysms
presence
of the associated
always
the
indication; rather,
surgical approach.
treatment for this condition is unclear. The authors
operative
is what dictates
severity coronary artery
In the absence of obstructive
a
the definitive
saccular left
was treated
(CAD)
CAD,
the case of an isolated
present
The
CAD.
flow-limiting
main
with no associated
coronary aneurysm
with
patient
no
events at
adverse
and
medication with
3, 6, 9,
medically
antiplatelet
anticoagulant
12
and
months of
follow-up.
Mostofthe isolated
coro-
Introduction
right coronary artery.l2
nary aneurysms
are atherosclerotic in
variant of
CAD.’ Atherosclerosis
and
origin
is an uncom-
are considered
a
(CAA)
Coronary artery aneurysm
mon
accounts for over 50% of
in
abnormality, diagnosed incidentally during
coronary aneurysms
or at
The
followed
Kawasaki disease and con-
adults,
coronary angiography
preva-
with
necropsy.
in
by
lence varies from
0.5% to
disease
4.9%
(CAD).
patients
genital etiology.4
The disease has
a
coronary artery is the least
with few
The left main
fre-
re-
coronary artery
male
a
the
for
and
involved
quently
a
case
predominance
predilection
artery,
only
in the world literature. 5,6 The natural
a
his-
ports
tory
remains
treatment of
tablished.
and
consensus on the
unclear,
has not
been es-
coronary aneurysm
include throm-
and
Reported complications
botic
thromboembolism,
with
obstructive
CAD
occlusion,
rupture,
2001
vasospasm.6In
52:501-504,
Angiology
Fromthe
patients
Cardiovascular
AugustaVAMedical
and
revascular-
Division,
of
Center,
aneurysm, myocardial
coronary
and the Medical
GA
College
Georgia, Augusta,
Pineda, MD,
1120 15th Street
ization is indicated .7 In the absence of obstruc-
Guillermo
Section of
Correspondence:
Cardiology,
the definite treatment for this
tive
tion
condi-
CAD,
Medical
College
of
BBR-6518,
Georgia,
in
is unclear. We describe
this
a
report
GA
pa-
30912
Augusta,
left main CAAand its follow-up
tient with
for
a
large
©2001 Westminster
Glen Cove
708
Publications, Inc.,
Avenue,
Glen
NY11545,
USA
to 12 months.
Head,
up
Jessafow
