A Coronary Artery Aneurysm with a Large Subepicardial Ischemia in a Patient Undergoing a Valvular Heart Surgery: Should a Coronary Artery Bypass be Combined or Not? A Case Report

Coronary artery aneurysm (CAA) is a rare coronary disease defined as a dilation of a coronary artery 1.5 times or more its normal size. It is often revealed by an acute myocardial infarction however sometimes it can be completely asymptomatic .Because of the relative rarity of this disease , there is no consensus on its management options and controversy persists regarding the use of medical or surgical modalities . The study report an unusual case of a CAA associated with a large subepicardial ischemia discovered incidentally in a patient undergoing surgery for severe mitral stenosis. The aim of this case report is to show the unusual association between coronary artery aneurysm and mitral stenosis, and to discuss the therapeutic management of coronary artery aneurysm in such an association, thereby demonstrating the necessity of elaborating recommendations for the management of coronary artery aneurysm.