medvisМедицинская визуализацияMedical Visualization1607-07632408-9516RDS-Media Ltd.10.24835/1607-0763-1112medvis-1112Research ArticleСЕРДЦЕ И СОСУДЫHEART AND VESSELSКлиническое наблюдение пациента с гигантской аневризмой левой коронарной артерииPatient with giant aneurism of the left coronary artery: a case reporthttps://orcid.org/0000-0001-6089-9722БазылевВ. В.BazylevV. V.

Базылев Владлен Владленович – доктор мед. наук, профессор, главный врач

440071 Пенза, ул. Стасова, 6

Vladlen V. Bazylev – Doct. of Sci. (Med.),  Chief doctor 

6, Stasova str., Penza 440071

cardio-penza@yandex.ruhttps://orcid.org/0000-0002-3795-2369КокшинД. В.KokshinD. V.

Кокшин Денис Вячеславович – врач-рентгенолог отделения лучевой диагностики

440071 Пенза, ул. Стасова, 6

Denis V. Kokshin – radiologist of radiology department 

6, Stasova str., Penza 440071

dennis-kv@mail.ruhttps://orcid.org/0000-0002-0067-801XПарамоноваТ. И.ParamonovaT. I.

Парамонова Татьяна Иннокентьевна – канд. мед. наук, врач-рентгенолог, заведующая отделением  лучевой диагностики

440071 Пенза, ул. Стасова, 6

Tatyana I. Paramonova – Cand. of Sci. (Med.), radiologist, Head of radiology department 

6, Stasova str., Penza 440071

cardio-penza@yandex.ruhttps://orcid.org/0000-0002-3553-4075ШматковМ. Г.ShmatkovM. G.

Шматков Марк Георгиевич – канд. мед. наук, заведующий отделением рентгенохирургических методов диагностики и лечения

440071 Пенза, ул. Стасова, 6

Mark G. Shmatkov – Cand. of Sci. (Med.), endovascular surgeon, Head of department

6, Stasova str., Penza 440071

cardio-penza@yandex.ruФГБУ “Федеральный центр сердечно-сосудистой хирургии” Минздрава РоссииFederal Centre for Cardiovascular Surgery2022110820222635764Copyright © Базылев В.В., Кокшин Д.В., Парамонова Т.И., Шматков М.Г., 20222022Базылев В.В., Кокшин Д.В., Парамонова Т.И., Шматков М.Г.Bazylev V.V., Kokshin D.V., Paramonova T.I., Shmatkov M.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://medvis.rdsmedia.ru/jour/article/view/1112Актуальность

Актуальность: гигантские аневризмы коронарных артерий являются чрезвычайно редкими находками. По данным зарубежных авторов, их распространенность в результате патологоанатомических исследований составила от 0,02 до 0,2%. Чаще всего они не имеют специфических симптомов и обнаруживаются после развития осложнений, таких как острый коронарный синдром, инфаркт миокарда. Риск внезапных осложнений обусловливает неблагоприятный прогноз заболевания и требует немедленной хирургической коррекции.

Цель исследования

Цель исследования: продемонстрировать эффективность методов лучевой диагностики в оценке коронарной анатомии и возможности наглядной визуализации перед планированием оперативного вмешательства.

Материал и методы

Материал и методы. Пациент был направлен в ФГБУ “ФЦССХ” Минздрава России (Пенза) для дообследования и оперативного лечения. До операции для уточнения особенностей макроморфологии аневризмы была выполнена селективная коронароангиография и КТ-коронарография.

Результаты

Результаты. До операции по данным КТ-коронарографии определяется частично тромбированная веретенообразная аневризма в передней нисходящей артерии с максимальным размером 7,0 × 3,5 см, прилежащая к стволу легочной артерии и ушку левого предсердия.

Заключение

Заключение. В современных условиях методы лучевой диагностики успешно применяются для уточнения локализации аневризм и индивидуальных топографоанатомических особенностях коронарных артерий.

Background

Background. Giant coronary artery aneurysms are extremely rare findings. According to foreign authors, their prevalence as a result of autopsy ranged from 0.02 to 0.2%. Most often, they do not have specific symptoms and are detected after the development of complications, such as acute coronary syndrome, myocardial infarction. The risk of sudden complications causes an unfavorable prognosis of the disease and requires immediate surgical correction.

Aim

Aim: to demonstrate the effectiveness of radiology methods in assessing coronary anatomy and the possibility of visualization before planning surgery.

Materials and methods

Materials and methods. The patient was referred to the Federal State Budgetary Institution “FCCVS” of the Ministry of Health of Russia (Penza) for additional examination and surgical treatment. Before surgery, to clarify the features of the macromorphology of the aneurysm, selective coronary angiography and CT coronary angiography were performed.

Results

Results. Before surgery, according to CT coronary angiography, a partially thrombosed fusiform aneurysm was detected in the anterior descending artery with a maximum size of 7.0 x 3.5 cm, adjacent to the pulmonary artery trunk and left atrial appendage.

Conclusion

Conclusion. In modern conditions, the methods of radiology are successfully used to clarify the localization of aneurysms and individual topographic and anatomical features of the coronary arteries.

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The authors declare that there are no conflicts of interest present.