Isolated Huge Aneurysm of the Left Main Coronary Artery in a 22-Year-Old Patient With Type 1 Neurofibromatosis Margaux Pontailler, MD, Didier Vilarem,

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Isolated Huge Aneurysm of the Left Main Coronary Artery in a 22-Year-Old Patient With Type 1 Neurofibromatosis Margaux Pontailler, MD, Didier Vilarem, MD, Jean-François Paul, MD, Philippe H. Deleuze, MD The Annals of Thoracic Surgery Volume 99, Issue 3, Pages 1055-1058 (March 2015) DOI: 10.1016/j.athoracsur.2014.05.062 Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 (A) Preoperative and (B) postoperative computed tomography scans show the left main coronary artery aneurysm. The postoperative contrast-enhanced computed tomography scan showed almost complete thrombosis of the aneurysm after surgical exclusion. The Annals of Thoracic Surgery 2015 99, 1055-1058DOI: (10.1016/j.athoracsur.2014.05.062) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 Coronary angiography of the left main coronary artery is seen in (A) right anterior oblique and (B) left anterior oblique views. The coronary angiography revealed a huge and unique aneurysm of the left main coronary artery encompassing the proximal portions of the circumflex artery and the left descending artery before their marginal and diagonal branches. The Annals of Thoracic Surgery 2015 99, 1055-1058DOI: (10.1016/j.athoracsur.2014.05.062) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 A perioperative view of the aneurysm, which was found behind the pulmonary trunk. The left descending and circumflex arteries arose from the distal edges of the aneurysm, before giving their collaterals. The Annals of Thoracic Surgery 2015 99, 1055-1058DOI: (10.1016/j.athoracsur.2014.05.062) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 A 3-dimensional reconstruction of a coronary computed tomography angiogram 1 week after the operation revealed good permeability of the 3 coronary arteries bypass grafts and exclusion of the aneurysm from the left coronary artery ostium. (ITA = internal thoracic artery; SVG = saphenous vein graft.) The Annals of Thoracic Surgery 2015 99, 1055-1058DOI: (10.1016/j.athoracsur.2014.05.062) Copyright © 2015 The Society of Thoracic Surgeons Terms and Conditions