Early rupture of a saphenous vein graft

Early rupture of a saphenous vein graft used for coronary artery surgery has not been previously reported. In a 69-year-old man having a third coronary by-pass procedure, one of the saphenous vein grafts ruptured on the 8th postoperative day. The other vein graft showed marked aneurysm formation at two sites. Histological examination of the ruptured graft revealed that this was due to a bacterial infection within the wall of the vein. Although he survived an emergency operation to control the haemorrhage and replace the ruptured graft, he died some days later of mediastinitis. It appeared that both the rupture of the graft and the ensuing mediastinitis were due to a primary infective process within the saphenous vein used for the graft.