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The patient was 75-year-old woman. The patient was referred to our hospital for operation due to a developing right coronary artery aneurysm. The coronary artery angiography showed that the aneurysm was 3 cm in diameter which had not existed two years previously, and with a 75% distal stenosis. The operation was made during cardiac arrest. A sapheous vein graft was used to bypass to the distal artery first. Then the aneurysm was resected, and both proximal and distal arteries were ligated. The pacemaker was implanted on the third postoperative day for sick sinus syndrome, the patient got a better recovery. Surgical treatment should be recommended to coronary artery aneurysm, and sapheous vein was a good selection for bypass graft when the diameter of native artery was relatively large.

A 44-year-old man complained of chest oppression and systolic murmur. Echocardiography showed subaortic stenosis with outflow gradient of 135 mmHg, interventricular septal thickness of 21 mm, left ventricular posterior wall thickness of 11 mm, and 2/4 mitral regurgitation. Selective coronary angiography demonstrated 75% stenosis in left anterior desending branch. Coronary artery revasculization comcomitant with left ventricular myotomy-myectomy was performed. He had a good recovery from operation, and was discharged in 19th days in NYHA class I. Echocardiography one month after operation showed mild outflow pressure gradient, light systolic anterior motion of mitral anterior leaflet, and 1/4 mitral regurgitation. Careful operative management, including myocardial protection, avoiding perporation of ventricular septum, and postoperative medical care are mandatory to this group of patients. The use of cathecholamine and Ca-blocker will be attentioned because of the increasing the left ventricular pressure gradient.