A CABG Complication - LIMA Graft to Cardiac Venous System Anastomosis Rescued by Percutaneous Coronary Intervention

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Complications

Background:

• Coronary artery bypass graft surgery (CABG) can rarely involve inadvertent anastomosis of a graft to the great anterior cardiac vein.
• Standard management options include graft embolization or surgical correction.
• Percutaneous coronary intervention (PCI) is an alternative approach for managing such complications.

Observation:

• A case of inadvertent left internal mammary artery (LIMA) graft anastomosis to the cardiac venous system was identified.
• The patient presented with anginal symptoms.
• No surgical correction or graft embolization was performed.

Findings:

• Percutaneous coronary intervention (PCI) successfully treated the underlying coronary artery disease (CAD).
• This approach resolved the patient's anginal symptoms.
• The inadvertent LIMA graft did not require embolization or surgical revision.

Implications:

• Percutaneous coronary intervention (PCI) offers a less invasive management strategy for inadvertent arterial grafts to the venous system in CABG patients.
• This approach can effectively address underlying coronary artery disease (CAD) and associated symptoms.
• It avoids the need for graft embolization or complex surgical intervention, potentially reducing patient morbidity.