IMR Press / RCM / Volume 23 / Issue 8 / DOI: 10.31083/j.rcm2308281
Open Access Original Research
Long-Term Outcomes of Conservative Versus Invasive Approach of Coronary Aneurysm
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1 Department of Cardiology, Toulouse University Hospital (Hopital Rangeuil), 31400 Toulouse, France
2 Department of Cardiology, Centre Hospitalier Intercommunal Castres-Mazamet, 81108 Castres, France
3 Faculty of Sciences, Paul-Sabatier Toulouse III University, 31062 Toulouse, France
4 Faculty of Medicine, Holy Spirit University of Kaslik, 446 Jounieh, Lebanon
*Correspondence: (Didier Carrié)
Academic Editors: Teruo Inoue and Daniel I. Simon
Rev. Cardiovasc. Med. 2022, 23(8), 281;
Submitted: 6 June 2022 | Revised: 19 June 2022 | Accepted: 7 July 2022 | Published: 10 August 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Introduction: Up to date, the management of coronary artery aneurysm (CAA) is not well defined and depends on local heart team decision. Data reported in literature are scarce and controversial. We aim to compare the long-term outcomes of different therapeutic strategies of CAA (medical vs percutaneous coronary intervention (PCI) vs coronary artery bypass graft(CABG)). Materials and Methods: A retrospective cohort study was conducted on 100 consecutive patients who underwent coronary angiography at Toulouse University Hospital, Toulouse France and fulfilled the diagnostic criteria of CAA. Coronary angiograms were reviewed, and all necessary data were collected. CAA was defined by a coronary dilation exceedingly at least 50% of reference coronary diameter. Results: We identified 100 patients with CAA with a mean age of 67.9 ± 12 years. The left anterior descending coronary artery was most affected (36%). CAA is associated with significant coronary artery disease in 78% of cases. The incidence of major adverse cardiovascular and cerebrovascular events (MACCE) was 13% during a median follow-up period of 46.2 ± 24 months. A 53% of patients underwent PCI or CABG. The rate of MACCE was lower in CABG group (9.1%) compared to PCI (14.3%) and medical (12.8%) groups, but without reaching statistically significant level. Longitudinal aneurysm diameter was positively linked to MACCE [OR = 1.109, 95% CI (1.014–1.214), p = 0.024]. No benefits have been attributed to anticoagulant regimen over antiplatelet therapy. Conclusions: In our retrospective observational study, there seems to be no significant differences in MACCE-free survival between all groups (Medical vs PCI vs CABG). Larger longitudinal aneurysm diameter was identified as a predictor of poor prognosis during follow-up.

coronary artery aneurysm
percutaneous coronary intervention
cardiac surgery
coronary artery disease
Fig. 1.
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