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Ruptured right coronary artery bypass graft aneurysm causing haemothorax

Laila Wali1, Amitkumar Sharma2, Kai Neoh2

  • 1Cardiology, Royal Liverpool University Hospital, Liverpool, UK laila.wali@liverpoolft.nhs.uk.

BMJ Case Reports
|May 28, 2026
PubMed

Insights

A rare and life-threatening complication of coronary artery bypass graft (CABG) vein graft aneurysms was identified. This case underscores the need for prompt recognition and tailored management strategies for these critical vascular conditions.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Radiology

Background:

  • Coronary artery bypass graft (CABG) surgery is a common procedure.
  • Vein graft aneurysms are a rare but serious complication.
  • Aneurysms can lead to life-threatening events such as rupture and hemorrhage.

Purpose of the Study:

  • To report a case of a ruptured coronary artery bypass graft vein graft aneurysm.
  • To highlight the diagnostic challenges and management considerations for this rare condition.
  • To emphasize the importance of early detection and individualized treatment plans.

Main Methods:

  • A case study of an elderly female patient with chest pain.
  • Diagnostic workup included D-dimer, CT pulmonary angiogram, and triphasic chest CT.
  • Multidisciplinary team discussion informed management decisions.

Main Results:

  • An incidental 5.4 cm aneurysm of the right coronary artery bypass vein graft was discovered.
  • The patient presented with symptoms suggestive of a ruptured aneurysm, leading to hematoma and hemothorax.
  • Conservative management was selected after shared decision-making.

Conclusions:

  • Ruptured vein graft aneurysms are a rare, critical complication of CABG.
  • Early recognition through advanced imaging is crucial.
  • Individualized management, considering patient factors and multidisciplinary input, is essential.

Keywords:
Cardiogenic ShockCardiovascular medicineInterventional cardiologyIschaemic heart disease

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