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Coronary artery bypass graft pseudoaneurysm communicating with the right atrium: a case report and review

C Nathaniel1, J C Missri

  • 1St. Francis Hospital and Medical Center, Hoffman Heart Institute of Connecticut, Hartford 06105, USA.

Insights

A pseudoaneurysm formed in a coronary artery bypass graft, causing abnormal drainage into the right atrium. This rare complication was diagnosed via cardiac catheterization in a patient with myocardial infarction.

Area of Science:

  • Cardiovascular Surgery
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Coronary artery bypass grafting (CABG) is a common procedure for treating coronary artery disease.
  • Pseudoaneurysms are rare but serious complications following cardiovascular interventions.
  • Fistulous communication between vascular grafts and cardiac chambers presents unique diagnostic and management challenges.

Observation:

  • A pseudoaneurysm was identified in the right coronary artery bypass graft.
  • The pseudoaneurysm exhibited fistulous drainage directly into the right atrium.
  • The patient presented with an acute myocardial infarction in a territory unrelated to the pseudoaneurysm.

Findings:

  • Cardiac catheterization successfully diagnosed the pseudoaneurysm and its fistulous connection.
  • The pseudoaneurysm represented a critical complication of the aortocoronary bypass graft.
  • Review of literature on pseudoaneurysms of aortocoronary bypass grafts is presented.

Implications:

  • Early diagnosis and appropriate management are crucial for patients with bypass graft pseudoaneurysms.
  • This case highlights the importance of considering rare graft complications in patients with complex cardiac presentations.
  • Understanding pseudoaneurysm formation and management can improve outcomes for patients undergoing CABG.

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