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Leaking false aneurysm of right coronary saphenous vein graft; successful treatment by percutaneous coil embolisation

W R Dimitri1, A W Reid, F G Dunn

  • 1Department of Cardiothoracic Surgery, Glasgow Royal Infirmary.

British Heart Journal
|December 1, 1992
PubMed

Insights

A rare complication after aortocoronary bypass grafting (CABG) involved a false aneurysm in the saphenous vein graft to the right coronary artery (RCA), causing significant bleeding. This condition was successfully treated with coil embolisation, stopping the bleeding and promoting healing.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Aortocoronary bypass grafting (CABG) is a common procedure for coronary artery disease.
  • Complications, though rare, can arise from bypass graft procedures.
  • Saphenous vein grafts are frequently used but can be susceptible to specific issues.

Observation:

  • An unusual complication of CABG presented as a false aneurysm of the saphenous vein graft to the right coronary artery (RCA).
  • This pseudoaneurysm led to profuse, intermittent bleeding from the sternotomy wound.
  • The etiology remains uncertain, possibly linked to suture lines and infection.

Findings:

  • Diagnosis was achieved non-invasively using contrast-enhanced computed tomography (CT).
  • Coronary bypass angiography confirmed the presence and extent of the pseudoaneurysm.
  • Successful treatment involved coil embolisation of the affected right coronary graft.

Implications:

  • Coil embolisation offers an effective minimally invasive treatment for saphenous vein graft pseudoaneurysms.
  • Prompt intervention can immediately control bleeding and facilitate wound healing.
  • Understanding potential graft complications is crucial for post-operative patient management.

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