Abstract
A 62-year-old man was diagnosed with a giant coronary artery aneurysm associated with immunoglobulin G4 (IgG4)-related disease. He had previously undergone two thoracic operations with sternotomies and abdominal aortic aneurysm repair for IgG4-related aortopathy. We opted for hybrid open and endovascular repair to reduce risk and avoid complications of a resternotomy and extracorporeal circulation. This first successful case of hybrid repair of a giant coronary artery aneurysm shows that the procedure is safe and feasible in patients with IgG4-related vasculopathy. It is critical to carefully monitor these patients for the occurrence of new IgG4-related aneurysms and other manifestations of vasculopathy.
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References
Crawley PD, Mahlow WJ, Huntsinger DR, Afiniwala S, Wortham DC. Giant coronary artery aneurysms: review and update. Tex Heart Inst J. 2014;41:603–8.
Lee WC, Fang HY, Fang CY. Hybrid strategy to treat life-threatening giant coronary artery aneurysm with severe in-stent restenosis. Int Heart J. 2017;58:283–5.
Stone JH, Zen Y, Deshpande V. IgG4-related disease. N Engl J Med. 2012;366:539–51.
Kasashima S, Zen Y, Kawashima A, Endo M, Matsumoto Y, Kasashima F. A new clinicopathological entity of IgG4-related inflammatory abdominal aortic aneurysm. J Vasc Surg. 2009;49:1264–71 (discussion 1271).
Matsuyama S, Kishigami T, Sakamoto M. A case of giant right coronary artery aneurysm due to IgG4-related disease. Gen Thorac Cardiovasc Surg. 2020;68:1453–6.
Nikolaidou CN, Vassiliou VS, Watson WD. Coronary artery aneurysms-a truly rare entity or simply unrecognized so far? Oxf Med Case Rep. 2019;29:omz009.
Li D, Wu Q, Sun L, Song Y, Wang W, Pan S, et al. Surgical treatment of giant coronary artery aneurysm. J Thorac Cardiovasc Surg. 2005;130:817–21.
Kim TH, Marfatia R, Lee J, Azrin M. Giant coronary aneurysm management with Viabahn covered stent. Cardiovasc Revasc Med. 2017;18:56–9.
Kawsara A, Núñez Gil IJ, Alqahtani F, Moreland J, Rihal CS, Alkhouli M. Management of coronary artery aneurysms. JACC Cardiovasc Interv. 2018;11:1211–23.
Szalat A, Durst R, Cohen A, Lotan C. Use of polytetrafluoroethylene-covered stent for treatment of coronary artery aneurysm. Catheter Cardiovasc Interv. 2005;66:203–8.
Stone JH, Khosroshahi A, Hilgenberg A, Spooner A, Isselbacher EM, Stone JR. IgG4-related systemic disease and lymphoplasmacytic aortitis. Arthritis Rheum. 2009;60:3139–45.
Sakai K, Watanabe T, Yoshida T. Endovascular treatment of immunoglobulin G4-related inflammatory abdominal aortic aneurysm. J Vasc Surg Cases Innov Tech. 2018;4:189–92.
Kasashima S, Kasashima F, Kawashima A, Endo M, Matsumoto Y, Kawakami K. Clinical outcomes after endovascular repair and open surgery to treat immunoglobulin G4-related and nonrelated inflammatory abdominal aortic aneurysms. J Endovasc Ther. 2017;24:833–45.
Tanigawa J, Daimon M, Takeda Y, Katsumata T, Ishizaka N. Temporal changes in serum IgG4 levels after coronary artery bypass graft surgery. Hum Pathol. 2012;43:2093–5.
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Kamikawa, Y., Ohashi, T., Tadakoshi, M. et al. Hybrid treatment of a giant coronary artery aneurysm in a patient with immunoglobulin G4-related disease. Gen Thorac Cardiovasc Surg 69, 1347–1351 (2021). https://doi.org/10.1007/s11748-021-01668-4
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DOI: https://doi.org/10.1007/s11748-021-01668-4