Case Session 04: Miscellaneous (2018)-Comprehensive coronary artery aneurysm assessment by CMR

Comprehensive coronary artery aneurysm assessment by CMR

Video Transcription

Video Summary

A 77-year-old man with a newly found large proximal right coronary artery aneurysm underwent CMR to assess aneurysm size, thrombus, ischemia, and scar. CMR showed a ~40 mm RCA aneurysm with probable thrombotic material, normal ventricular function, but marked stress perfusion defect in the RCA territory. Rest perfusion was only mildly delayed, suggesting true stenosis rather than simple blood pooling. Late gadolinium enhancement showed a small subendocardial scar. Coronary angiography confirmed subtotal RCA stenosis at the aneurysm entrance. The patient underwent surgical aneurysm resection and RCA reconstruction with a saphenous vein graft.

Keywords

right coronary artery aneurysm

cardiac magnetic resonance

stress perfusion defect

subendocardial scar

coronary angiography