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Surgical management of multiple giant coronary artery aneurysms determining myocardial ischemia

Coronary artery aneurysms (CAAs) are rare lesions in which the optimal management is poorly defined. We present a series of three patients with diffuse symptomatic coronary artery disease and giant CAAs, on the circumflex branch (6 × 5 cm ‐ Patient 1), on the proximal right coronary artery (5 × 6 cm ‐ Patient 2) and on the proximal left anterior descending (LAD) (4 × 5 cm ‐ Patient 3). Standard coronary artery bypass grafting (LIMA‐on‐LAD plus sequential saphenous vein) and associated CAA exclusion by proximal and distal ligation was performed according to the coronary anatomy. Six month follow‐up computed tomography scan control showed complete exclusion of the CAA in all three patients.