Management of giant right coronary artery aneurysm fistula into the left ventricle: a clinical case report and review of the medical literature

Abstract

Background: A giant right coronary artery aneurysm fistula into the left ventricle is an extremely rare disease with a high risk of complications such as thrombosis, heart failure, and rupture, .... We describe a case of giant right coronary artery aneurysm fistula into the left ventricle and compare it with medical literature review to clarify the pathology and treatment strategy of this disease.

Materials and methods: A report of a clinical case involving a giant right coronary artery aneurysm with a fistula into the left ventricle which was diagnosed and treated successful at Can Tho Central General Hospital.

Results: A 51-year-old female patient was diagnosed with a giant right coronary artery aneurysm fistula into the left ventricle, successfully diagnosed and treated by surgical repair of the fistula with autologous pericardium and her postoperative condition was stable. The patient was treated as an outpatient with Aspirin combined with Vitamin K1 antagonist, then stop taking medication without permission. She was readmitted to the hospital due to chest pain, and a chest CT scan showed thrombosis of almost the entire right coronary artery. The patient was treated with intravenous heparin. The patient's chest pain was gone and she was discharged, continuing to maintain Aspirin and Vitamin K1 antagonist on an outpatient basis.

Conclusion: Giant right coronary artery aneurysm with a fistula to the left ventricle is an extremely rare disease with significant risks and complications. Surgical repair of the fistula in this case is a safe and effective method. A close collaboration among the medical team, including internists, interventional cardiologists, radiologists, cardiac surgeons, and post-operative care physicians, is essential, along with the patient's adherence to treatment.