抄録
A 42-year-old man was referred to our hospital due to a coronary artery aneurysm(8mm in diameter) after percutaneous coronary intervention. He had a history of acute myocardial infarction in the left anterior descending artery(LAD) and balloon angioplasty three months previously. Coronary artery bypass grafting (CABG) was performed using cardiopulmonary bypass and cardioplegia. At the operation, a pseudo-aneurysm was found between 1st and 2nd septal branch. A longitudinal incision of 40mm length was made on the LAD across the aneurysm and stenosis. The left internal thoracic artery(LITA) was anastomosed with 8-0 prolene sutures(on-lay patch). The 3 dimension computed tomography before discharge showed disappearance of the aneurysm and good patency of the LITA graft to the LAD. Although PCI-related coronary artery aneurysm was relatively rare. Once it is found, surgical treatment was recommended due to the threat of rupture. Although plication or ligation of the coronary aneurysm and distal coronary bypass have been recommended, on-lay patch CABG may be useful and can be an option to avoid sacrifice of the major branches near by the aneurysm.
