Infected aneurysm of coronary artery: methods of diagnosys and treatment

Authors: Skopin I.I., Abdulgasanov R.A., Gasymov E.G., Abdulgasanova M.R.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2021-15-4-456-467

For citation: Skopin I.I., Abdulgasanov R.A., Gasymov E.G., Abdulgasanova M.R. Infected aneurysm of coronary artery: methods of diagnosys and treatment. Creative Cardiology. 2021; 15 (4): 456–67 (in Russ.). DOI: 10.24022/1997-3187-2021-15-4-456-467

Received / Accepted:  20.03.2021 / 25.11.2021

Keywords: сoronary artery disease infected coronary artery aneurysm mycotic coronary artery aneurysm

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Abstract

Infected coronary artery aneurysm (ICAA) is rare complication of pre-existing coronary artery disease of atherosclerotic or other genesis, percutaneous coronary intervention (PCI), infective endocarditis or extracardiac infection, accompanied by high mortality. 83–86% of infected patients are males, with average age of 55.44 years. The most frequently affected vessel is right coronary artery (40–45%). In 53.3–55% of cases, the etiological pathogen is Staphylococcus aureus, in 20–21% – Streptococcus. Usually, IACA have a large size, reaching an average of 3.4 cm, however, an increase of up to 9 cm is possible. According to computed tomography (CT) angiography, in 54.2% of cases, a lobular contour or saccular shape of the coronary artery are visualized, in 87.5–89% of cases, a thickening of the wall or parietal thrombi are detected, in 79.2–81% – pericardial thickening or pericardial effusion. IACA usually has a lobular or saccular shape, reach significant sizes and are characterized by a thickening of the coronary artery wall. This complication is often accompanied by hydropericardium. The identification of these changes in the patient, along with fever, an already existing infectious process, or a recent history of PCI allow to suspect IACA.

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About Authors

  • Ivan I. Skopin, Dr. Med. Sci., Professor, Head of Department, Director of the Institute of Coronary and Vascular Surgery; ORCID
  • Ramiz A. Abdulgasanov, Dr. Med. Sci., Chief Researcher for Department of Arterial Pathology; ORCID
  • Emil’ G. Gasymov, Resident Physician; ORCID
  • Mekhriban R. Abdulgasanova, Physician-Applicant; ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery