Nevertheless, COVID-19 can affect the vascular endothelium, and the pathogenesis of coronary artery aneurysms is not yet well understood. impact of COVID-19 on the occurrence of coronary artery aneurysm may be necessary, considering the alleged correlation between COVID-19 and vascular complications. strong class=”kwd-title” Keywords: coronary artery aneurysm, coronavirus disease 2019, adult 1. Introduction As coronavirus disease 2019 (COVID-19) cases have been accumulated, various associated complications have KIAA1823 been reported. It is well known that COVID-19 can affect the vascular endothelium through the previously published studies. Multicenter case series concerning multiple system inflammatory syndrome involving coronary arteries in children and adolescents have also been published [1,2]. However, coronary artery aneurysm complicated by COVID-19 in adults has not yet been reported. Herein, we report a case of a newly developed right coronary artery aneurysm in an adult with recent COVID-19. 2. Case Presentation A 66-year-old man on hemodialysis was admitted to our hospital for further evaluation of newly Lapaquistat acetate developed chest pain. He had diabetes mellitus, hypertension, and a history of cerebral infarction. He had a history of coronary stent implantation in the left anterior descending artery at its mid- and distal portions and in the left circumflex artery (LCx) at its proximal portion 17 months prior. On coronary angiograms performed at that time, there were no findings suggestive of coronary artery dilatation, aneurysm, Lapaquistat acetate or ectasia (Video S1). He was regularly followed up with dual antiplatelet therapy thereafter. Four months prior to this presentation, a polymerase chain reaction test confirmed the diagnosis of COVID-19, for which he was admitted to another hospital because of combined pneumonia and his comorbidities for about a month. One month prior, he had received his first COVID-19 vaccination (Vaxzevria; AstraZeneca, Oxford, UK). To investigate the association between newly developed chest pain and coronary lesions, the patient underwent diagnostic coronary angiography, which revealed a large coronary artery aneurysm with a diameter of 8.6 mm at the proximal portion of the right coronary artery (RCA) and multiple stenotic lesions on the RCA and LCx (Video S2). Transthoracic echocardiography showed an ejection fraction of 40%, with hypokinesia of the base to mid inferior wall and basal inferolateral wall, and akinesia of the mid inferolateral wall. Magnetic resolution cerebral angiography showed no aneurysmal changes to the cerebral arteries. The initial C-reactive protein level was within normal limits. The patient and the heart team decided to perform surgical interventions to treat him for both multiple stenotic lesions and the coronary aneurysm simultaneously. Coronary artery bypass grafting was performed using an on-pump beating strategy Lapaquistat acetate without cardiac arrest. One saphenous vein graft was anastomosed to the distal RCA, while the other was anastomosed to the obtuse marginal branch of the LCx. Suture ligation of the RCA aneurysm at its proximal and distal portions was also performed (Figure 1). Postoperative coronary computed tomographic angiograms obtained 7 days after surgery showed patent vein grafts and no contrast enhancement in the RCA aneurysm (Figure 2). His medical center program was uneventful. He was followed up for 5 weeks after release without complications regularly. Open in another window Shape 1 Operative Results. (A) The proper coronary artery was subjected at its proximal part (white arrow). (B) Suture ligation was performed in the proximal and distal servings of the proper coronary artery aneurysm (dark arrow). Open up in another window Shape 2 Postoperative Computed Tomography Locating. Computed tomography exposed how the bypass grafts had been patent without comparison complete the aneurysmal part of the proper coronary artery. 3. Dialogue Coronary artery aneurysm can be a uncommon disease entity regarded as due to atherosclerosis, Kawasaki disease, congenital anomaly, mycotic disease, connective cells disease, and arteritis . As medical data regarding COVID-19 due to severe severe respiratory symptoms coronavirus 2 continue.
Nevertheless, COVID-19 can affect the vascular endothelium, and the pathogenesis of coronary artery aneurysms is not yet well understood