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The Coincidence of 3 Different Rare Coronary Artery Anomalies in an Adult Patient With Untreated Kawasaki Disease

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ABSTRACT

The coincidence of 3 different rare coronary artery anomalies is extremely rare, and has not been reported so far.

We report multiple imaging findings of a giant coronary artery aneurysm, which has a fistulous connection to the right ventricle associated with anomalous origin of the anterior descending coronary artery from the right coronary artery in a 67-year-old woman who suffered with a 20-year history of progressively chest distress on exertion and a history of untreated Kawasaki disease in her childhood.

The patient received surgical treatment. The aneurysm was resected and openings at both ends being oversewn. And the fistula was also closed directly. She recovered and discharged uneventfully.

The coincidence of 3 different rare coronary artery anomalies in adult patient with untreated Kawasaki disease is a rare and complicated condition, in which surgical treatment is recommended.

No MeSH data available.


Related in: MedlinePlus

(A) Three-dimensional heart reconstruction of CT images. The left main coronary artery fed the aneurysm. (B) Volume-rendered MSCT imaging. LAD arose from the proximal of the right coronary artery and passed to the left and descended to the anterior interventricular groove. MSCT = multi-slice computed tomography.
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Figure 2: (A) Three-dimensional heart reconstruction of CT images. The left main coronary artery fed the aneurysm. (B) Volume-rendered MSCT imaging. LAD arose from the proximal of the right coronary artery and passed to the left and descended to the anterior interventricular groove. MSCT = multi-slice computed tomography.

Mentions: Multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) both revealed a saccular aneurysm locating in interventricular septum in which there was a fixed density/signal lesion that was not enhanced by the contrast media, and the enlarged, tortuous left main coronary artery supplied this aneurysm. MSCT also revealed anomalous origin of the anterior descending coronary artery arising from the RCA and the anterior descending coronary artery passing to the left and descended to the anterior interventricular groove (Figure 2B). And the aneurysm had a fistulous connection with the RV was detected by MRI, which showed a small bundle of flow drained into the RV using 3D TOP technique (Figure 3A) and a signal-free space (flow void) within the fistula in black blood sequence (Figure 3B).


The Coincidence of 3 Different Rare Coronary Artery Anomalies in an Adult Patient With Untreated Kawasaki Disease
(A) Three-dimensional heart reconstruction of CT images. The left main coronary artery fed the aneurysm. (B) Volume-rendered MSCT imaging. LAD arose from the proximal of the right coronary artery and passed to the left and descended to the anterior interventricular groove. MSCT = multi-slice computed tomography.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998408&req=5

Figure 2: (A) Three-dimensional heart reconstruction of CT images. The left main coronary artery fed the aneurysm. (B) Volume-rendered MSCT imaging. LAD arose from the proximal of the right coronary artery and passed to the left and descended to the anterior interventricular groove. MSCT = multi-slice computed tomography.
Mentions: Multi-slice computed tomography (MSCT) and magnetic resonance imaging (MRI) both revealed a saccular aneurysm locating in interventricular septum in which there was a fixed density/signal lesion that was not enhanced by the contrast media, and the enlarged, tortuous left main coronary artery supplied this aneurysm. MSCT also revealed anomalous origin of the anterior descending coronary artery arising from the RCA and the anterior descending coronary artery passing to the left and descended to the anterior interventricular groove (Figure 2B). And the aneurysm had a fistulous connection with the RV was detected by MRI, which showed a small bundle of flow drained into the RV using 3D TOP technique (Figure 3A) and a signal-free space (flow void) within the fistula in black blood sequence (Figure 3B).

View Article: PubMed Central - PubMed

ABSTRACT

The coincidence of 3 different rare coronary artery anomalies is extremely rare, and has not been reported so far.

We report multiple imaging findings of a giant coronary artery aneurysm, which has a fistulous connection to the right ventricle associated with anomalous origin of the anterior descending coronary artery from the right coronary artery in a 67-year-old woman who suffered with a 20-year history of progressively chest distress on exertion and a history of untreated Kawasaki disease in her childhood.

The patient received surgical treatment. The aneurysm was resected and openings at both ends being oversewn. And the fistula was also closed directly. She recovered and discharged uneventfully.

The coincidence of 3 different rare coronary artery anomalies in adult patient with untreated Kawasaki disease is a rare and complicated condition, in which surgical treatment is recommended.

No MeSH data available.


Related in: MedlinePlus