Abstract
Coronary artery aneurysms (CAA) are rare and most commonly associated with atherosclerosis. Post-PCI CAA formation is an unusual complication, with a limited understanding of its mechanisms. We herein report a case of dissecting CAA diagnosed 14 years after drug-eluting stent (DES) placement, which gradually enlarged over time. The aneurysm was surgically managed with plication and coronary artery bypass grafting (CABG), along with simultaneous aortic valve replacement and mitral valve repair. This case underscores the importance of long-term imaging follow-up after PCI, especially in patients with complex dissections, and it also highlights surgical plication as a viable option for managing CAA in the context of combined cardiac surgery.
