Abstract
A 41-year-old African American woman presented with chest pain and was found to have
non-ST segment elevation myocardial infarction with a peak cardiac troponin I of 28.5.
Elective cardiac catheterization revealed a 70% ostial left anterior descending (LAD)
artery stenosis. The patient underwent percutaneous coronary intervention and a sirolimus-eluting
stent (Cypher, Miami, FL, 3.5 × 8 mm) was successfully deployed. Three years after
stent implantation, the patient presented with recurrent angina. Repeat coronary angiography
revealed a large aneurysm involving the proximal portion of the stent with a total
occlusion at the mid to distal portion of the stent with collaterals to LAD from left
circumflex artery. The patient underwent coronary artery bypass surgery with left
internal mammary artery graft to LAD and ligation of LAD at its origin proximal to
the aneurysm.
Keywords
coronary artery aneurysm - coronary artery bypass - sirolimus-eluting stent - percutaneous
coronary intervention
