Minimally invasive off-pump coronary surgery via left mini-thoracotomy for a left coronary artery aneurysm in a female: A case report
- 1Department of Cardiovascular Surgery, Izumiotsu Medical Center, Osaka, Japan
Abstract
Coronary artery aneurysm is a rare condition commonly treated with conventional surgery under cardiopulmonary bypass because of its complexity. Here, we present a patient who underwent minimally invasive off-pump coronary surgery via left mini-thoracotomy for a left anterior descending artery saccular aneurysm. A Japanese woman in her late 40s, who had been treated with beta-blocker therapy for hypertrophic cardiomyopathy, and steroid and immunosuppressive therapies after renal transplantation, developed chest discomfort on effort recently. Digital Holter electrocardiography showed ST-segment depression associated with exertional dyspnea, suggesting ischemic heart disease. Coronary angiography revealed a saccular aneurysm of the left anterior descending artery that had caused ischemia due to turbulence. This patient was diagnosed with a left coronary artery aneurysm causing ischemic symptoms, which indicated surgical intervention, whereas we judged that the mild to moderate mitral valve regurgitation and mild left ventricular outflow stenosis, caused by hypertrophic cardiomyopathy, did not require surgical interventions. Then, we performed aneurysmal plication after bypass grafting to the left anterior descending by the left internal thoracic artery via left mini-thoracotomy under off-pump guidance. The patient recovered well, and the symptoms disappeared. Postoperative computed tomography angiography showed good patency of the internal thoracic artery and complete disappearance of the aneurysm. This case demonstrates the potential utility of minimally invasive off-pump coronary surgery via left mini-thoracotomy as a useful alternative for patients with simple left coronary artery aneurysms.
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BibTeX
@article{morisaki2026minimally,
title = {{Minimally invasive off-pump coronary surgery via left mini-thoracotomy for a left coronary artery aneurysm in a female: A case report}},
author = {Akimasa Morisaki and Kokoro Yamane and Toshihiko Shibata},
journal = {Therapeutic Advances in Cardiovascular Disease},
year = {2026},
month = sep,
doi = {10.1177/17539447261493436},
url = {https://doi.org/10.1177/17539447261493436},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Minimally invasive off-pump coronary surgery via left mini-thoracotomy for a left coronary artery aneurysm in a female: A case report
AU - Akimasa Morisaki
AU - Kokoro Yamane
AU - Toshihiko Shibata
PY - 2026
DA - 2026/09/28
JO - Therapeutic Advances in Cardiovascular Disease
DO - 10.1177/17539447261493436
UR - https://doi.org/10.1177/17539447261493436
AB - Coronary artery aneurysm is a rare condition commonly treated with conventional surgery under cardiopulmonary bypass because of its complexity. Here, we present a patient who underwent minimally invasive off-pump coronary surgery via left mini-thoracotomy for a left anterior descending artery saccular aneurysm. A Japanese woman in her late 40s, who had been treated with beta-blocker therapy for hypertrophic cardiomyopathy, and steroid and immunosuppressive therapies after renal transplantation, developed chest discomfort on effort recently. Digital Holter electrocardiography showed ST-segment depression associated with exertional dyspnea, suggesting ischemic heart disease. Coronary angiography revealed a saccular aneurysm of the left anterior descending artery that had caused ischemia due to turbulence. This patient was diagnosed with a left coronary artery aneurysm causing ischemic symptoms, which indicated surgical intervention, whereas we judged that the mild to moderate mitral valve regurgitation and mild left ventricular outflow stenosis, caused by hypertrophic cardiomyopathy, did not require surgical interventions. Then, we performed aneurysmal plication after bypass grafting to the left anterior descending by the left internal thoracic artery via left mini-thoracotomy under off-pump guidance. The patient recovered well, and the symptoms disappeared. Postoperative computed tomography angiography showed good patency of the internal thoracic artery and complete disappearance of the aneurysm. This case demonstrates the potential utility of minimally invasive off-pump coronary surgery via left mini-thoracotomy as a useful alternative for patients with simple left coronary artery aneurysms.
SN - 1753-9447
SN - 1753-9455
ER -