Innominate artery aneurysms are an uncommon pathology. There are several pathogenic mechanisms involved in their formation, and patients are usually asymptomatic. However, different clinical presentations are possible. Management varies according to anatomic characteristics. Surgical treatment is recommended in order to avoid complications. We present a case of a patient with an innominate artery aneurysm found incidentally during surgery for myocardial revascularization. A 77-year-old male with unstable angina secondary to multivascular ischemic heart disease was subjected to surgery. Coronary angiography did not evaluate the aortic arch and its branches. During the surgical procedure we found a 2-cm saccular aneurysm at the origin of the innominate artery. After completing the revascularization procedure and once the patient was no longer on cardiopulmonary bypass, aneurysmorrhaphy was successfully done.
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