Surgical management of multiple giant coronary artery aneurysms determining myocardial ischemia.

Coronary artery aneurysms (CAAs) are rare lesions in which the optimal management is poorly defined. We present a series of three patients with diffuse symptomatic coronary artery disease and giant CAAs, on the circumflex branch (6 × 5 cm - Patient 1), on the proximal right coronary artery (5 × 6 cm - Patient 2) and on the proximal left anterior descending (LAD) (4 × 5 cm - Patient 3). Standard coronary artery bypass grafting (LIMA-on-LAD plus sequential saphenous vein) and associated CAA exclusion by proximal and distal ligation was performed according to the coronary anatomy. Six month follow-up computed tomography scan control showed complete exclusion of the CAA in all three patients.