Sevil GÜLAŞTI, Davut Barış ÇIÇEK, Mehmet KAYA, Emre PINAR, Çağdaş AKGÜLLÜ, Cemil ZENCİR
Medical Records - 2026;8(1):1905714-1905714
Aim: Coronary artery ectasia (CAE) is a rare coronary artery anomaly defined as dilatation of a coronary artery segment to at least 1.5 times the diameter of the adjacent normal segment. Structural abnormalities of the vascular wall may contribute to both CAE and aortic aneurysm formation. This study aimed to determine the prevalence of CAE in patients operated on for ascending aortic aneurysm and to evaluate the relationship between ascending aortic diameter, CAE, and coronary flow characteristics. Material and Methods: This retrospective observational study included patients who underwent surgery for ascending aortic aneurysm between 2015 and 2025 and had preoperative coronary angiography. Demographic characteristics, cardiovascular risk factors, ascending aortic diameter, and angiographic findings were recorded. CAE was defined as dilatation exceeding 1.5 times the diameter of the adjacent normal segment and was classified according to the Markis classification. Coronary slow flow was evaluated using the TIMI frame count method. Factors associated with CAE were analyzed using logistic regression analysis. Results: A total of 115 patients were included, and CAE was detected in 36 (31.3%). Patients with CAE were older than those without CAE (63.6 +/- 9.5 vs. 58.9 +/- 10.8 years, p = 0.026), and hyperlipidemia was more frequent in the ectasia group (p = 0.012). Ascending aortic diameter differed significantly between groups (p = 0.048). In multivariable logistic regression, age remained independently associated with CAE. The right coronary artery was the most frequently involved vessel, and Markis type I and type III were the most common ectasia patterns. TIMI frame count values and slow-flow extent did not differ significantly between groups. Conclusion: CAE was identified in a considerable proportion of patients undergoing surgery for ascending aortic aneurysm. Older age was independently associated with CAE, supporting a possible link between ascending aortic aneurysm and coronary ectatic remodeling.
