Cardiology - Case Reports
Vol. 92 No. 2 (2022)
https://doi.org/10.4081/monaldi.2021.2048

A challenging pacemaker implantation in the presence of a giant right coronary aneurysm compressing the right atrium

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Received: 12 August 2021
Accepted: 13 September 2021
Published: 22 November 2021
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Pacemaker implantation, Giant coronary aneurysm, echocardiography

Authors

Stefano Maffè
stemaffe@libero.it
https://orcid.org/0000-0002-1007-5570
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Paola Paffoni
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Luca Bergamasco
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Eleonora Prenna
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Giulia Careri
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Emanuela Facchini
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Lara Baduena
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Nicolò Franchetti Pardo
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.
Pierfranco Dellavesa
Division of Cardiology, SS Trinita’ Borgomanero Hospital, ASL NO, Novara, Italy.

Giant coronary artery aneurysm is an uncommon disease, treated with surgical intervention or percutaneous coil embolization. A thrombosed aneurysm can cause extrinsic compression on the cardiac chambers, with potential hemodynamic effects and may cause problems when we need to implant a cardiac device. We present a case of difficult pacemaker implantation in a patient with 3 syncopes, first-degree AV block and complete left bundle branch block on electrocardiogram. The patient presented a giant aneurysm of the right coronary artery (85 x 90 mm), thrombosed, with right atrial compression. The pacemaker implantation was hampered by the difficulty of passing the lead through the compressed right atrium; indeed, only with simultaneous echocardiographic and fluoroscopic guidance, was it possible to complete the procedure. This case demonstrates the utility of echocardiogram, in particular settings, in cardiac stimulation procedures.

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How to Cite



“A Challenging Pacemaker Implantation in the Presence of a Giant Right Coronary Aneurysm Compressing the Right Atrium”. 2021. Monaldi Archives for Chest Disease 92 (2). https://doi.org/10.4081/monaldi.2021.2048.
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