Prevalence and Natural History of Coronary Ostial Aneurysms in Marfan Patients.
J Comput Assist Tomogr. 2019 Jan/Feb;43(1):115-118. doi: 10.1097/RCT.0000000000000799.
Haroun RR, Chu LC, Fishman EK.
OBJECTIVE: The aim of this study was to determine the prevalence and natural history of coronary ostial aneurysms in Marfan patients with aortic root replacement.
METHODS: Thirty-one Marfan patients (mean age, 33.7 ± 11.8 years) who underwent aortic root replacement and postoperative electrocardiogram-gated computed tomographic (CT) angiograms between January 2007 and December 2015 were retrospectively identified. A subset of 15 patients underwent follow-up CT angiograms. Computed tomographic angiograms were postprocessed on 3-dimensional software to measure maximal coronary ostial diameter. Coronary ostial aneurysm was defined as diameter of greater than 10 mm.
RESULTS: Right coronary ostial aneurysms were present in 45.2% (14/31) of patients, and left main coronary ostial aneurysms were present in 51.6% (16/31) of patients. Mean ostial diameter was 10.1 ± 1.9 mm for the right coronary artery and 10.0 ± 1.8 mm for the left coronary artery. In a subset of patients with follow-up CT angiograms, there was no significant change in coronary ostial diameter on follow-up examinations (P > 0.05).
CONCLUSIONS: Coronary ostial aneurysms were common in Marfan patients after aortic root replacement. These findings remain stable over time and may have little clinical consequence.