Iatrogenic giant coronary artery pseudoaneurysm with "daughter aneurysm" formation: serial imaging findings and natural history.

Coronary pseudoaneurysms rarely occur spontaneously; rather, they are more commonly seen as a complication of coronary intervention. We present a case of a giant right coronary artery pseudoaneurysm with partial thrombosis after arterial perforation during percutaneous intervention for acute myocardial infarction and formation of a "daughter aneurysm" due to a contained rupture 12 years later. Right coronary pseudoaneurysm repair and coronary artery bypass grafting were eventually performed 16 years after the acute event. Cardiac magnetic resonance imaging, coronary computed tomography angiography, and autopsy findings are shown.

[1]  D. Walters,et al.  Percutaneous treatment of an occlusive left main pseudoaneurysm: a role for multimodality imaging. , 2011, Cardiovascular Revascularization Medicine.

[2]  M. Alidoosti,et al.  Conservative approach for perforation and early pseudoaneurysm of left anterior descending artery during overlapped stenting. , 2009, The Journal of invasive cardiology.

[3]  D. Jassal,et al.  Multimodality imaging of a right saphenous vein graft pseudoaneurysm. , 2008, Canadian Journal of Cardiology.

[4]  H. Izutani,et al.  Spontaneous right coronary artery pseudoaneurysm , 2007, General thoracic and cardiovascular surgery.

[5]  Hui Meng,et al.  Mathematical model of the rupture mechanism of intracranial saccular aneurysms through daughter aneurysm formation and growth , 2005, Neurological research.

[6]  A. Iskandrian,et al.  Spontaneous Coronary Artery Dissection, Aneurysms, and Pseudoaneurysms: A Review , 2004, Echocardiography.

[7]  C. Higgins,et al.  Structure: Organized Pericardial Hematomas: Magnetic Resonance Imaging , 2000 .

[8]  C. Higgins,et al.  Organized pericardial hematomas: magnetic resonance imaging. , 2000, Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance.

[9]  W. Voelker,et al.  Occurrence of a saccular pseudoaneurysm formation two weeks after perforation of the left anterior descending coronary artery during balloon angioplasty in acute myocardial infarction , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[10]  U. Sechtem,et al.  Delayed development of a coronary artery pseudoaneurysm after angioplasty , 1999, Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions.

[11]  R. Lazzara,et al.  Giant Coronary Artery Pseudoaneurysm Causing Pulmonary Artery Obstruction: A Rare Complication of Coronary Bypass Surgery , 1997, Angiology.