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Case Reports in Cardiology
Volume 2018, Article ID 9738530, 4 pages
https://doi.org/10.1155/2018/9738530
Case Report

Transcatheter Aortic Valve Replacement Incidentalomas: A Multimodality Imaging Case of Giant Right Coronary Aneurysm

1Department of Internal Medicine, Gundersen Health System, La Crosse, WI 54601, USA
2Department of Cardiology, Gundersen Health System, La Crosse, WI 54601, USA
3Department of Cardiothoracic Surgery, Gundersen Health System, La Crosse, WI 54601, USA
4Department of Pathology, Gundersen Health System, La Crosse, WI 54601, USA

Correspondence should be addressed to Jamal Janjua; moc.liamg@aujnajlamaj

Received 23 November 2017; Revised 15 February 2018; Accepted 3 March 2018; Published 26 March 2018

Academic Editor: Ertugrul Ercan

Copyright © 2018 Jamal Janjua et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Giant coronary artery aneurysms (CAAs) are defined as having a diameter of greater than 2 cm. We report a case of an 82-year-old male with severe aortic stenosis incidentally diagnosed with giant right coronary artery aneurysm (gRCAA) while undergoing evaluation for transcather aortic valve replacement (TAVR). It was causing a mass effect on the right cardiac chambers but was otherwise asymptomatic. Our patient was successfully treated with surgical excision of aneurysm with concomitant coronary artery bypass grafting (CABG) and surgical aortic valve replacement (SAVR). The patient remained stable at discharge and on serial follow-ups for two years. In conclusion, due to the associated complication and increased risk of mortality with giant coronary aneurysms, we recommend surgical approach instead of medical management alone. We also call for evidence-based recommendations and guidelines for management of TAVR incidentalomas.