PMC3641980_01
Frontal view of chest demonstrates an abnormal double density along the right heart border (arrowheads).
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F1
Initial imaging with chest X-ray (Figure 1) was performed and a contrast enhanced computed tomography (CT) scan of the chest revealed a low attenuation mass located along the right heart anteriorly that measured approximately 10 cm by 10 cm with no significant enhancement (Figure 2).
Axial image from CTA. There is a large mass (**) with mural calcifications (arrowheads). There is marked compression of the tricuspid valve and mid-heart regions (arrow) between the right atrium (A) and right ventricle (V).
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F2
Initial imaging with chest X-ray (Figure 1) was performed and a contrast enhanced computed tomography (CT) scan of the chest revealed a low attenuation mass located along the right heart anteriorly that measured approximately 10 cm by 10 cm with no significant enhancement (Figure 2).
CT Reconstruction of Aneurysm - Blood-pool inversion volume rendered 4-chamber image shows the extent of luminal compression and restriction in diastolic filling of the RV and tricuspid areas (arrowheads) by the mass (*).
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F3
CT reconstructions were also performed, which revealed the extent of right heart obstruction by the aneurysm (Figure 3).
Intra-operative Images of Giant Right Coronary Artery Aneurysm Resection. (A) Mobilization of aneurysm prior to institution of cardiopulmonary bypass. (B) Surgical exposure of the lesion demonstrates a giant aneurysm (**) that is contiguous with the right coronary artery (arrow). (C) Opened giant aneurysm with obstructive thrombus (*). (D) Intraluminal thrombus (arrows) adherent to the intimal layer of the giant aneurysm.
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F4
Intra-operative examination of the lesion revealed a true saccular aneurysm measuring approximately 10 cm by 10 cm that nearly obliterated the right atrial cavity and severely compressed the right ventricle (Figure 4A-D).