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Aortocoronary saphenous vein bypass aneurysm--an unusual presentation

C L Schamroth1, A D Sacks

  • 1Department of Cardiology, Milpark Hospital, Johannesburg.

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
|May 22, 1998
PubMed

Insights

Atherosclerotic aneurysms of aortocoronary saphenous vein grafts are rare, typically appearing over 10 years post-surgery. This case highlights a rare presentation causing angina due to compression of the native coronary artery.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Medicine
  • Medical Imaging

Background:

  • Aneurysms of aortocoronary saphenous vein grafts (ACSVGA) are infrequent complications following coronary artery bypass grafting (CABG).
  • Literature reports approximately 30 cases, with atheromatous aneurysms typically manifesting more than a decade after the initial surgery.

Observation:

  • Atheromatous aneurysms are often asymptomatic and may be incidentally discovered as mediastinal contour abnormalities on imaging.
  • This report details a specific case where the aneurysm presented symptomatically.

Findings:

  • The patient presented with angina pectoris, a symptom of myocardial ischemia.
  • The angina was attributed to the atherosclerotic aneurysm compressing the adjacent native coronary artery, compromising blood flow.

Implications:

  • This case underscores the importance of considering graft aneurysms in the differential diagnosis of late-presenting graft dysfunction or chest pain post-CABG.
  • Recognizing this rare complication is crucial for appropriate patient management and preventing adverse cardiac events.
  • Further investigation into the pathophysiology and long-term surveillance of ACSVGA may be warranted.

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