The strange case of a nest in the chest - Image 14

Image in Interventional Cardiovascular Medicine: what is displayed on this image? ... and do not hesitate to comment how you would treat this case!

In this case, a large coronary aneurysm in the distal right coronary artery was detected shortly after an atrio-ventricular node ablation procedure. Thermal damage of the adjacent coronary artery wall due to overheating of previously implanted coronary stents, albeit not reported in the literature, was considered as the possible mechanism. Owing to the peceived high risk of rupture, implantation of a covered stent was attempted; however with no success due to the distal obstruction of the vessel and the inabilty to pass over the aneurysm with a hydrophilic and then a polymeric 0.014 guidewire, over a guidewire extention (Guideliner).

An image is worth a 1,000 words: tell us what you see in this image!

Authors