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Heart. May 1998; 79(5): 505–508.
PMCID: PMC1728704

Aneurysms and pseudoaneurysms of saphenous vein coronary artery bypass grafts

Abstract

Aneurysms of saphenous vein grafts to coronary arteries are unusual complications of coronary artery bypass graft (CABG) surgery. Three patients (men aged 47, 62, and 68 years) are presented with spontaneous chest pains 10, 21, and 17 years after CABG surgery. In one case, the saphenous vein graft had eroded into the right atrium and had established a fistula between the graft and the right atrium. Diagnosis of saphenous vein graft aneurysms was confirmed by echocardiography, computed tomography or magnetic resonance imaging, and by arteriography. Two patients were treated surgically, the third by percutaneous coil embolisation followed by balloon angioplasty of the right coronary artery.

Keywords: aneurysm;  pseudoaneurysm;  saphenous vein grafts;  coronary artery bypass graft

Figure 1
(A) Admission chest x ray of case 2 with a widened mediastinum and a right paracardiac mass; (B) chest x ray three years earlier.
Figure 2
Case 2: Large pseudoaneurysm of the saphenous vein graft to the RCA (30° right anterior oblique view).
Figure 3
Magnetic resonance image of case 3 showing a 7 × 5 cm mass in the left mediastinum adjacent to the pulmonary artery trunk.
Figure 4
(A) Angiography of case 3 showing a large aneurysm of the LAD saphenous vein graft at the level of the distal anastomosis. (B) Angiography after coil embolisation.

Articles from Heart are provided here courtesy of BMJ Group