RESUMO
This case report presents a unique instance of mycotic pseudoaneurysm in the proximal right coronary artery (RCA) following percutaneous coronary intervention (PCI) in a 75-year-old male with a complex medical history. Despite successful initial intervention and resolution of bacteremia, the patient presented three months later with recurrent anginal symptoms. The diagnostic evaluation revealed a mycotic pseudoaneurysm in the RCA, leading to surgical clipping and graft implantation. The successful surgical outcome underscores the critical role of early recognition and intervention in enhancing patient survival. This case contributes valuable insights into the diagnostic intricacies and therapeutic nuances of mycotic pseudoaneurysm, reinforcing the importance of maintaining a heightened index of suspicion, particularly in patients with a history of coronary interventions.
RESUMO
BACKGROUND: Coronary artery pseudoaneurysm is a rare disease that can rupture and cause haemopericardium. It can occur principally as a complication after coronary artery instrumentation, but it can also result from trauma. CASE SUMMARY: A 15-year-old male patient with a history of spontaneous pneumothoraces treated twice with video-assisted thoracoscopic thoracic surgery presented with pericarditis and increasing haemopericardium. During the hospitalization, he had developed cardiogenic shock and he underwent emergent pericardiocentesis. Coronary angiography revealed a small right coronary artery pseudoaneurysm. We successfully coil embolized the pseudoaneurysm. DISCUSSION: This is a rare case of a ruptured coronary artery pseudoaneurysm associated with prior tube thoracostomy. The treatments for a coronary pseudoaneurysm should be tailored based on the pathologic and anatomical characteristics.
RESUMO
Coronary artery aneurysm and pseudoaneurysm are rare and mainly result from atherosclerosis. We present a successfully treated case of a giant right coronary artery aneurysm and pseudoaneurysm with a coronary artery fistula, which might have developed after cardiac surgery for a right ventricular tumor 35 years earlier. (Level of Difficulty: Advanced.).
RESUMO
A 78-year-old man presented with chest pain and ST segment elevation. Coronary angiography showed no significant coronary artery disease. A saccular pocket of contrast material was found outside of the distal right posterior descending coronary artery consistent with a pseudoaneurysm. Echocardiography showed a pocket of pericardial fluid behind the left atrium concerning for a hemopericardium. The pseudoaneurysm was treated urgently with two coils successfully deployed to obtain complete exclusion of the pseudoaneurysm sac and occlusion of the distal portion of the posterior descending coronary artery.