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Saphenous vein graft aneurysm-an unusual cause of mediastinal mass
Daniel D Correa de Sa1, Thais Coutinho, Paul Sorajja
1University of Vermont, Burlington, USA.
Abstract:
We report the case of a 78-year-old man who was incidentally found to have a large, ovoid mass on a chest X-ray. Nineteen years before, he had undergone a coronary artery bypass graft (CABG). A chest computed tomography (CT) scan revealed a 6.8 x 6.7 cm aneurysm of the saphenous vein bypass graft anastomosed to the distal right coronary artery with contrast filling only the proximal end of the graft. The inferior wall of the left ventricle was akinetic on echocardiography, suggesting prior myocardial infarction of this vascular bed. Because of the patient's comorbidities, occlusion of the graft, and prior inferior infarction, clinical observation was elected.
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The azygos vein, positioned just right of the midline and anterior to the vertebral column, begins at the junction of the right ascending lumbar and subcostal veins, terminating in the superior vena cava. This vein drains blood from the right side of the thoracic wall, thoracic viscera, and posterior abdominal wall.
The...