{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T18:06:02Z","timestamp":1787162762826,"version":"build-2736575974"},"reference-count":13,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T00:00:00Z","timestamp":1757462400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Coronary artery aneurysms (CAAs) are an uncommon finding, and their rupture is an exceedingly rare and life-threatening complication. Giant aneurysms of the left main coronary artery (LMCA) pose a significant diagnostic and therapeutic challenge. We describe the case of a 62-year-old male who presented with acute coronary syndrome and was subsequently diagnosed with a ruptured giant LMCA aneurysm causing cardiac tamponade and multi-organ dysfunction. The initial diagnosis was suggested by coronary angiography and confirmed with contrast-enhanced multidetector computed tomography (MDCT) and echocardiography. The patient underwent emergency surgery consisting of aneurysm excision, thrombectomy, ligation of the LMCA ostium and its distal branches (LAD and circumflex), and coronary artery bypass grafting (CABG) using the left internal thoracic artery to the left anterior descending artery and a saphenous vein graft to a marginal branch. The patient\u2019s postoperative course was complicated by transient multi-organ dysfunction, which resolved. He was discharged in a stable condition. This case highlights the critical importance of rapid multimodal imaging for diagnosis and the feasibility of emergency surgical intervention to achieve a favorable outcome in patients with a ruptured giant LMCA aneurysm.<\/jats:p>","DOI":"10.3390\/diagnostics15182302","type":"journal-article","created":{"date-parts":[[2025,9,10]],"date-time":"2025-09-10T15:39:23Z","timestamp":1757518763000},"page":"2302","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Surgical Management of a Ruptured Giant Left Main Coronary Artery Aneurysm Presenting with Cardiac Tamponade"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4204-8865","authenticated-orcid":false,"given":"Dmitriy","family":"Shumakov","sequence":"first","affiliation":[{"name":"M.F. Vladimirsky Moscow Regional Clinical Research Institute, Schepkina St. 61\/2, 129110 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitriy","family":"Zybin","sequence":"additional","affiliation":[{"name":"M.F. Vladimirsky Moscow Regional Clinical Research Institute, Schepkina St. 61\/2, 129110 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Stepanova","sequence":"additional","affiliation":[{"name":"M.F. Vladimirsky Moscow Regional Clinical Research Institute, Schepkina St. 61\/2, 129110 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0547-6310","authenticated-orcid":false,"given":"Siarhei","family":"Dabravolski","sequence":"additional","affiliation":[{"name":"Department of Biotechnology Engineering, Braude Academic College of Engineering, Snunit 51, P.O. Box 78, Karmiel 2161002, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Sigaleva","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Problems, Russian Academy of Sciences, 76A Khoroshevskoye Shosse, 123007 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0246-5149","authenticated-orcid":false,"given":"Ekaterina","family":"Silina","sequence":"additional","affiliation":[{"name":"Department of Hospital Surgery, Pirogov Russian National Research Medical University, 117997 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9522-8061","authenticated-orcid":false,"given":"Victor","family":"Stupin","sequence":"additional","affiliation":[{"name":"Department of Hospital Surgery, Pirogov Russian National Research Medical University, 117997 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0316-8410","authenticated-orcid":false,"given":"Mikhail","family":"Popov","sequence":"additional","affiliation":[{"name":"M.F. Vladimirsky Moscow Regional Clinical Research Institute, Schepkina St. 61\/2, 129110 Moscow, Russia"},{"name":"Institute of Biomedical Problems, Russian Academy of Sciences, 76A Khoroshevskoye Shosse, 123007 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1161\/01.CIR.67.1.134","article-title":"Aneurysmal Coronary Artery Disease","volume":"67","author":"Swaye","year":"1983","journal-title":"Circulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1017\/S1047951120000426","article-title":"Kawasaki Disease with Giant Aneurysm of Left Coronary Artery and Complete Occlusion of Right Coronary Artery","volume":"30","author":"Muneer","year":"2020","journal-title":"Cardiol. Young"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.carpath.2016.01.001","article-title":"Multiple Giant Coronary Artery Aneurysms: A Case Report","volume":"25","author":"Jacobi","year":"2016","journal-title":"Cardiovasc. Pathol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"446","DOI":"10.4330\/wjc.v13.i9.446","article-title":"Coronary Artery Aneurysm: A Review","volume":"13","author":"Matta","year":"2021","journal-title":"World J. Cardiol."},{"key":"ref_5","first-page":"2077","article-title":"Treatment of Ruptured Giant Coronary Aneurysm","volume":"40","author":"Naoum","year":"2024","journal-title":"Can. J. Cardiol."},{"key":"ref_6","first-page":"35","article-title":"Giant Aneurysm of the Left Main Coronary Artery: A Case Report","volume":"13","author":"Yayla","year":"2018","journal-title":"J. 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Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"15","DOI":"10.31762\/AHJ2433.0302","article-title":"Emergence of Computed Tomography Angiography in Evaluation and Management of Diverse Coronary Artery Anomalies: A Single Center Registry","volume":"33","author":"Raval","year":"2024","journal-title":"ASEAN Heart J."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/jocs.14276","article-title":"Surgical Management of Multiple Giant Coronary Artery Aneurysms Determining Myocardial Ischemia","volume":"35","author":"Garatti","year":"2020","journal-title":"J. Card. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.1016\/j.athoracsur.2015.06.104","article-title":"Bilateral Giant Coronary Artery Aneurysms Complicated by Acute Coronary Syndrome and Cardiogenic Shock","volume":"101","author":"Chiu","year":"2016","journal-title":"Ann. Thorac. 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