Aneurysm of Aortocoronary Saphenous Vein Graft:
AbstractTrue aneurysms of aortocoronary saphenous vein bypass grafts are a relatively rare complication of bypass surgery, but because the complications of thrombosis, embolization, or rupture are potentially fatal, this condition requires immediate surgical intervention. We describe a 78-year-old man who had undergone coronary bypass 15 years previously and who presented with a saphenous vein graft that was severely degenerated and aneurysmally enlarged throughout its course, measuring as much as 5 to 6 cm in certain locations. Redo coronary artery bypass grafting using the right and left internal thoracic arteries and resection of the aneurysm were performed. We also present a review of the literature regarding diagnosis, management, and treatment of this condition.
Benchimol A, Jarros CL, Desser KB, Fleming H. 1975. Aneurysm of an aortocornary artery saphenous vein bypass graft--a case report. Vasc Surg 9:261-4.nBramlet DA, Behar VS, Ideker RE. 1982. Aneurysm of a saphenous vein bypass graft associated with aneurysms of native coronary arteries. Cathet Cardiovasc Diagn 8:489-94.nChalasani P, Konlan D, Clements S. 1997. Paracardiac masses caused by a right coronary artery aneurysm and a saphenous vein graft aneurysm. Clin Cardiol 20:79-81.nDimitri WR, Reid AW. 1992. Coronary bypass graft aneurysm. Ann Thorac Surg 54:395.nDouglas BP, Bulkley BH, Hutchins GM. 1979. Infected saphenous vein graft coronary artery bypass graft with mycotic aneurysm. Chest 75:76-7.nDzavik V, Lemay M, Chan KL. 1989. Echocardiographic diagnosis of an aortocoronary venous bypass graft aneurysm. Am Heart J 118:619-21.nEnnis BM, Zientek DM, Ruggie NT, Billhardt RA, Klein LW. 1993. Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three-dimensional reconstruction. Cath Cardiovasc Diagn 28:328-31.nForster DA, Haupert MS. 1991. Large mediastinal mass secondary to an aortocoronary saphenous vein bypass graft aneurysm. Ann Thorac Surg 52:547-8.nTaliercio CP, Smith HC, Pluth JR, Gibbons RJ. 1986. Coronary artery venous bypass graft aneurysm with symptomatic coronary artery emboli. J Am Coll Cardiol 7:435-7.nTeja K, Dillingham R, Mentzer RM. 1987. Saphenous vein aneurysms after aortocoronary bypass grafting: postoperative interval and hyperlipidemia as determining factors. Am Heart J 113:1527-9.nWerthman PE, Sutter FP, Flicker S, Goldman SM. 1992. Spontaneous late rupture of an aortocoronary saphenous vein graft. Ann Thorac Surg 51:664-6.nWester DJ, Martinez HO, Camp A. 1993. Aneurysm of a saphenous vein graft manifested as a mediastinal mass on chest radiographs. Am J Roent gen 161:951-2.nWyatt DA, Gay SB, Gimple LW, Spotnitz WD. 1993. Successful preoperative diagnosis and treatment of a saphenous vein coronary artery bypass graft aneurysm. Chest 104:283-4.nYousem D, Scott W, Fishman EK, Watson AJ, Traill T, Gimenez L. 1986. Saphenous vein graft aneurysms demonstrated by computed tomography. J Comput Assist Tomogr 3:526-8.nRobiscek F, Harbold NB, Cappelman WF, Matos-Cruz M. 1993. Aneurysm of saphenous vein graft used for aorta-coronary bypass, resembling an anterior mediastinal mass. J Thorac Cardiovasc Surg 105:949-51.nRosin MD, Ridley PD, Maxwell PH. 1989. Rupture of a pseudoaneurysm of a saphenous vein coronary arterial bypass graft presenting with superior caval venous obstruction. Intern J Cardiol 25:121-3.nSahouri SJ, Steele RL. 1995. Aneurysm of saphenous vein graft to coronary artery presenting as non-Q-wave myocardial infarction secondary to mass effect. Cath Cardiovasc Diagn 34:325-8.nShapeero LG, Guthaner DF, Swerdlow CD, Wexler L. 1983. Rupture of a coronary bypass graft aneurysm: CT evaluation and coil occlusion. Am J Roentgenol 141:1060-2.nSherry CS, Harm SE. 1989. MR imaging of pseudoaneurysms in aortocoronary bypass graft. J Comput Assist Tomogr 13:426-9.nSmith JA, Goldstein J. 1992. Saphenous vein graft pseudoaneurysm formation after postoperative mediastinitis. Ann Thorac Surg. 54:766-8.nMohara J, Konishi H, Kato M, Misawa Y, Kamisawa O, Fuse K. 1998. Saphenous vein graft pseudoaneurysm after coronary artery bypass grafting. Ann Thorac Surg 65:831-2.nMurphy JP, Shabb B, Nishikawa A, Adams PR, Walker WE. 1986. Rupture of an aortocoronary saphenous vein graft aneurysm. Am J Cardiol 58:555-7.nNathaniel C, Missri JC. 1996. Coronary artery bypass graft pseudoaneurysm communicating with the right atrium: a case report and review. Cath Cardiovasc Diagn 38:80-2.nNeilson JF, Stentoft J, Aunsholt NA. 1988. Haemoptysis caused by aneurysm of saphenous bypass graft to a coronary artery. Scand J Thorac Cardiovasc Surg 22:189-91.nPintar K, Barboriak JJ, Johnson WD, Eddy D. 1978. Atherosclerotic aneurysm in aortocoronary artery saphenous vein graft. Arch Pathol Lab Med 102:287-8.nRiahi M, Stone KS, Hanni CL, Fierens E, Dean RE. 1984. Right ventricular-saphenous vein graft fistula. J Thorac Cardiovasc Surg 87:626-8.nRiahi M, Vasu CM, Tomatis LA, Schlosser RJ, Zimmerman G. 1975. Aneurysm of saphenous vein bypass graft to coronary artery. J Thorac Cardiovasc Surg 70:385-9.nHughes MM, Rice TW, Simpfendorfer C. 1991. Aneurysmal saphenous vein graft presenting as an anterior mediastinal mass. Cath Cardiovasc Diagn 24:265-7.nJukema JW, van Dijkman PRM, van der Wall EE. 1992. Pseudoaneurysm of a saphenous vein coronary artery bypass graft with a fistula draining into the right atrium. Am Heart J 124:1397-9.nKallis P, Keogh BE, Davies MJ. 1993. Pseudoaneurysm of aortocoronary vein graft secondary to late venous rupture: case report and literature review. Br Heart J 70:189-92.nKarwande SV, Sharp SD. 1990. Saphenous vein graft pseudoaneurysm presenting as a mediastinal mass. Texas Heart Inst 17:129.nKim D, Guthaner DF, Wexler L. 1983. Transcatheter embolization of a leaking pseudoaneurysm of saphenous vein aortocoronary bypass graft. Cathet Cardiovasc Diagn 9:591-4.nLiang BT, Antman EM, Taus R, Collins JJ, Schoen FJ. 1988. Atherosclerotic aneurysms of aortocoronary vein grafts. Am J Cardiol 61:185-8.nLopez-Velarde P, Hallman GL, Treistman B. 1988. Aneurysm of an aortocoronary saphenous vein bypass graft presenting as an anterior mediastinal mass. Ann Thorac Surg 46:349-50.n
How to Cite
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).