UNASSIGNED: A 74-year-old @entity1 underwent coronary artery bypass graft surgery. Thirteen years later, he presented with complaints of exertional anterior chest oppression again. Computed tomography coronary angiography revealed the significant @entity850 at the mid right coronary artery (RCA). In addition, a giant proximal left anterior descending (LAD) @entity574 ( @entity574 ) was found. We did not observe this @entity439 on his previous coronary angiogram, performed 12 years previously (i.e., 1 year after his surgery). Diagnostic coronary angiography confirmed the computed tomography findings. We found the significant @entity850 at the mid RCA site and a giant proximal @entity574 . First, we performed the percutaneous coronary intervention (PCI) at the mid RCA significant @entity850 . We implanted the drug eluting stent. After that, we performed PCI to treat the giant proximal @entity574 with a covered stent (a 2.8/26-mm @entity736 covered stent), and complete exclusion of the @entity439 was obtained. The etiology of this @entity1 's @entity439 was unclear, but we speculate that the mechanism responsible for the appearance of this @entity439 was the expansion of the intra-plaque cavity with the ruptured fibrous cap. This observation over time through coronary angiography suggests that giant CAAs might be generated asymptomatically under certain conditions. In this case, the possible conditions might have been the chronic total occlusion of the mid-LAD and the significant @entity850 just distal to this @entity439 , so increasing flow and pressure against this diseased cavity might have caused this giant @entity574 to form. In addition, another speculation might have been the local inflammation or macrophage-based degradation after coronary artery bypass graft surgery.

Generation of a XXXX from an intra-plaque cavity with a ruptured fibrous cap: an observation over time through coronary angiography.

@entity1 :: ('9606', 'Species') :: ['patient', 'man'] @entity439 :: ('MESH:D000783', 'Disease') :: ['aneurysm'] @entity736 :: ('CHEBI:53251', 'Chemical') :: ['polytetrafluoroethylene'] @entity850 :: ('MESH:D003251', 'Disease') :: ['stenosis'] @entity574 :: ('MESH:D003323', 'Disease') :: ['coronary artery aneurysm', 'LAD coronary artery aneurysm', 'CAA']
@entity574 :: (MESH:D003323,Disease) :: ['giant coronary artery aneurysm']
