Afebrile mycotic aneurysm with rupture in right coronary artery after bare-metal stent implantation

Mycotic coronary aneurysm is a rare complication of coronary angioplasty. We report an unusual case, a 58-year-old male with diabetes mellitus and end-stage renal disease, who underwent bare-metal stent implantation at the right coronary artery for acute coronary syndrome. The patient subsequently developed mycotic aneurysm at the stenting site which manifested as chest pain and severe back pain. Later, a lethal aneurysm rupture occurred, resulting in cardiac tamponade. Surgical debridement with emergent coronary artery bypass grafting was carried out, and post-surgical tissue specimen culture grew methicillin-resistant Staphylococcus aureus. The patient died of mediastinitis and massive bleeding 2 weeks after the operation. Thereafter, we completed a review of the literature due to the rarely-occurring nature of this patient's case.