PMC7242977_01
The CT scanner detected two giant aneurysmal sacs on the right coronary artery. (a) the 12-lead electrocardiogram showed sinus rhythm with a rate of 70 beats and incomplete right bundle branch block; (b) Coronal plain view of CTA; (c,d) Sagital plain view of CTA; (e,f) axial plain view of CTA; (g) three-dimension view of aneurymal sacs; (*) the first aneurymal sac; (**) the second aneurymal sac.
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On diagnostic work up, the 12-lead electrocardiogram showed sinus rhythm with a rate of 70 beats and incomplete right bundle branch block (Fig. 1a). The chest computed tomography (CT) scanner was immediately indicated and it confirmed that there were two giant aneurysmal sacs in the right coronary artery (RCA) (Fig. 1g). The first aneurysm was 32 x 36 mm in size and located in the proximal RCA, the second one containing thrombus was 43 x 30 mm in the middle RCA (Fig. 1b,c,d,e,f).
(a) The intraperative image of proximal aneurysmal sac (*). (b) The cardiopulmonary bypass was set through the ascending aorta, superior and inferior vena cava.
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Two aneurysmal sacs (Fig. 2a,b) with thrombus were exposed, until approach the normal distal and proximal coronary arteries diameter, inflow ligated and resected, the outflow was sutured.
The postoperative enhanced CT of the chest was performed one-month post-CABG and the coronary reconstructions by GSV revealed patent (orange arrow).
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A postoperative enhanced CT of the chest was performed one-month post-CABG and the coronary reconstructions by GSV revealed patent (Fig. 3).
Histopathological examination showed the degeneration due to atherosclerosis.
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The histopathological results of the two aneurysms showed the degeneration due to atherosclerosis (Fig. 4).