Coronary artery aneurysms may predispose to acute thrombosis, embolisation and myocardial
ischaemia or rupture with subsequent tamponade and/or sudden death. The optimal therapy
for patients with coronary artery aneurysm is unknown, and controversy persists regarding
the use of medical or surgical modalities. There is no doubt that surgical therapy
is reserved for cases with large aneurysms or with myocardial ischaemia due to significant
associated coronary artery stenoses. We discuss here the surgical management of a
case with coronary artery aneurysm and concomitant coronary artery disease. Although
the beating heart technique of myocardial revascularisation and repair of coronary
artery aneurysm without cardiopulmonary bypass is not suitable for all patients, it
should be considered for those high-risk patients who have impaired left ventricular
function or who are at high risk for pulmonary or neurological complications.
Coronary artery aneurysm - atherosclerosis - off-pump coronary artery bypass
