Ruptured aortic sinus aneurysm with left coronary artery aneurysm-right
atrial fistula
Abstract
A 50-year-old female presented with a history of fatigue after
activities. Transthoracic echocardiography showed a 2.8 cm dilatation at
the ostium of the left coronary artery and a 7.1×7.4 cm cyst-like
aneurysm at the upper back of the left atrium, interlinking an anomalous
fistula from the left coronary artery to the right atrial appendage,
accompanied by moderate mitral and tricuspid regurgitation. Cardiac
3D-computed tomography identified the diagnosis of ruptured aortic sinus
aneurysm (RASA) and a giant left coronary artery aneurysm fistula to the
right atrium. Transesophageal echocardiogram and surgical vision
confirmed these findings. Surgeries including RASA repair, coronary
artery bypass grafting, and mitral and tricuspid valvuloplasty were then
performed. Procedures proceeded successfully, the patient was fully
recovered and discharged home.