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Published on: November 19, 2019
Vanishing Venous Coronary Artery Bypass Grafts after Sepsis
Soo Jin Park1, Ji Ye Park1, Joonho Jung1
1Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine.
Insights
Saphenous vein graft (SVG) dehiscence after coronary artery bypass grafting (CABG) is rare but serious. This case highlights infection as a cause, emphasizing prevention and management strategies for this life-threatening complication.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Surgical Complications
Background:
- Coronary artery bypass grafting (CABG) is a common procedure.
- Saphenous vein grafts (SVGs) are frequently used conduits.
- Graft dehiscence is a rare but potentially fatal complication.
Observation:
- A 57-year-old male developed streptococcal sepsis post-CABG and hemiarch repair.
- Twenty-five months after surgery, complete rupture of proximal SVG anastomoses occurred.
- The rupture was contained by the obliterated pericardial cavity.
Findings:
- Infection (streptococcal sepsis) was identified as the cause of SVG dehiscence.
- The patient's SVG rupture was successfully managed with surgical intervention.
- This case underscores the link between infection and graft failure.
Implications:
- Highlights the critical need for vigilance regarding graft integrity in patients with sepsis post-CABG.
- Emphasizes the importance of early diagnosis and management of infection to prevent catastrophic graft complications.
- Provides insights into preventive measures and surgical strategies for managing SVG dehiscence secondary to infection.
Abstract:
The dehiscence of saphenous vein grafts (SVGs) is a rare, often fatal, complication of coronary artery bypass grafting (CABG). We present the case of a 57-year-old man who underwent hemiarch graft interposition and CABG for a Stanford type A aortic dissection. Five months after discharge, the patient developed streptococcal sepsis caused by a hemodialysis catheter. Complete rupture of the proximal anastomoses of the saphenous veins and containment by the obliterated pericardial cavity was observed 25 months after the initial operation. The patient was successfully treated surgically. This report describes a patient who developed potentially fatal dehiscence of SVGs secondary to infection and outlines preventive and management strategies for this complication.
