Fissurating aneurysm of the right coronary artery repaired with interposition of a Gore-Tex graft

Coronary artery aneurysms are exceedingly rare and are most often discovered incidentally. Rupture of such aneurysms is even more uncommon. In this case report, we describe an 82-year-old patient who presented with sudden-onset chest pain and was diagnosed with a fissurating aneurysm of the right coronary artery. The aneurysm was associated with a congenital abnormality of the coronary venous sinus return. The patient underwent emergency surgery. Given her advanced age, the surgical strategy focused solely on addressing the imminent risk of rupture. A 10-mm Gore-Tex graft was implanted because direct suture repair or vein grafting was deemed unsuitable. The patient recovered well postoperatively and was given dual antiplatelet therapy. At nine months of follow-up, she remains asymptomatic, with no recurrence of chest pain.