Experience with a Coronary Vein Aneurysm Diagnosed by Exploratory Thoracoscopy

Abstract

Reports on coronary vein aneurysms are rare; however, an association with the atrioventricular accessory pathway has become clear in recent years, and it could be a potential cause of arrhythmia. The patient was a 55-year-old male. He visited our department due to a suspected paracardiac mass which was identified on a plain CT as part of a detailed examination during a medical check-up. Owing to the difficulty of making a diagnosis by contrast-enhanced CT, MRI, etc., thoracoscopic surgery was performed. The surgery was completed by means of exploratory thoracoscopy after identifying a thoracoscopic coronary vein aneurysm; subsequently, a diagnosis was made in conjunction with the findings from a post-operative electrocardiogram-gated cardiac CT. Based on the fact that the aneurysm was not associated with arrhythmia, that it occurred relatively distant from the coronary sinus, and that the thrombosis inside was extremely small, we determined that resection was not necessary. The patient was thereafter closely observed in order to prevent any rupture due to enlargement of the mass.