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Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
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Thrombosed aneurysm of saphenous vein coronary artery bypass grafting

Rodolfo Mendes Queiroz1, Rogério Nastri1, Marcus Antônio Ferez1,2

  • 1Radiology and Imaging Diagnosis Department, Documenta - Hospital São Francisco, Ribeirão Preto, SP, Brazil.

Revista Da Associacao Medica Brasileira (1992)
|September 7, 2017
PubMed

Insights

A rare, potentially fatal complication of coronary artery bypass grafting (CABG) surgery, saphenous vein graft aneurysm, was diagnosed in a 76-year-old male. Early recognition is crucial for patient outcomes.

Area of Science:

  • Cardiovascular Surgery
  • Diagnostic Imaging
  • Vascular Medicine

Background:

  • Coronary artery bypass grafting (CABG) using saphenous vein grafts (SVG) is a common revascularization procedure.
  • SVG aneurysms are infrequent but serious late complications, often presenting asymptomatically.
  • Patients with a history of CABG require vigilant monitoring for potential graft-related issues.

Observation:

  • A 76-year-old male presented with chest pain and dyspnea, with a history of myocardial infarction and prior CABG.
  • Echocardiography suggested a pericardial cyst, but computed angiotomography revealed a thrombosed aneurysm of the SVG to the right coronary artery.
  • The aneurysm was predominantly fusiform in shape.

Findings:

  • Computed angiotomography is effective in diagnosing SVG aneurysms.
  • SVCABG aneurysms are rare, potentially fatal, and typically manifest years after surgery.
  • Diagnosis can be challenging due to asymptomatic presentation and varied imaging findings.

Implications:

  • Routine surveillance imaging in patients with a history of CABG may be warranted to detect rare but critical complications like SVG aneurysms.
  • Prompt diagnosis and management of SVG aneurysms are essential to prevent life-threatening events.
  • This case highlights the importance of considering graft complications in the differential diagnosis of cardiac symptoms in post-CABG patients.

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