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Updated: Jun 17, 2026

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
09:04

Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg

Published on: November 19, 2019

[Large saphenous vein graft aneurysm after coronary artery bypass grafting]

T Hachimaru1, M Watanabe, S Kawaguchi

  • 1Department of Cardiovascular Surgery, Hiroo Hospital, Tokyo, Japan.

Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 17, 2009
PubMed

Insights

A large saphenous vein graft aneurysm was successfully removed without coronary bypass surgery. This approach avoided complex re-grafting in a patient with severe coronary artery disease.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery

Background:

  • Coronary artery bypass grafting (CABG) using saphenous vein grafts (SV) can lead to late complications.
  • Saphenous vein graft aneurysms are a known, albeit uncommon, complication following CABG.

Observation:

  • A 64-year-old male presented with a progressively enlarging saphenous vein graft (SVG) aneurysm in the SVG-right coronary artery (RCA) anastomosis, measuring 53 x 44 mm.
  • Initial surgical planning involved off-pump coronary artery bypass surgery and aneurysmectomy, but severe adhesions and calcification of the RCA precluded re-grafting.

Findings:

  • Aneurysmectomy was successfully performed without the need for coronary bypass due to sufficient distal coronary artery backflow.
  • The patient experienced no hemodynamic or electrocardiographic changes during the procedure and was discharged 9 days post-surgery.

Implications:

  • This case demonstrates the feasibility of aneurysmectomy without bypass for large SVG aneurysms when re-grafting is technically challenging.
  • Successful management of SVG aneurysms can be achieved through tailored surgical strategies, preserving coronary perfusion.

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