Abstract
Aneurysmal dilation of saphenous vein grafts is a relatively rare complication of the now common surgical procedure of coronary artery bypass graft (CABG) surgery. The true prevalence of this condition is not clear, however, literature review by Jorgensen et. al. between 1975 and 2002 revealed only 76 published cases. [1] Recent review of literature, utilizing OVID (search terms: saphenous vein, aneurysm, graft, pseudoaneurysm, coronary bypass) suggests a significantly higher prevalence with 14 such cases published in a variety of multinational journals during the period of 2006 to April 2007. The causes of this dramatic increase is likely multifactorial, however, in the author's opinion, likely reflects the increased sophistication and utilization of cross sectional imaging modalities. Regardless of the true prevalence of the condition, there is little debate that the potential for serious morbidity and mortality in this patient population is significant, and that increased detection and discussion of viable therapeutic options is critical. [1] Therefore, we present a case report and discussion of a patient with symptomatic cardiac ischemia, found to have a large saphenous vein graft aneurysm (SVGA) on coronary CTA.
Highlights
Our patient is a 61 year old male with a history of coronary artery disease (CAD), hypertension (HTN), and hyperlipidemia (HPL) who was successfully treated with 4 vessel coronary artery bypass graft (CABG) in 1997 for symptomatic disease
[1] we present a case report and discussion of a patient with symptomatic cardiac ischemia, found to have a large saphenous vein graft aneurysm (SVGA) on coronary CTA
Our patient is a 61 year old male with a history of coronary artery disease (CAD), hypertension (HTN), and hyperlipidemia (HPL) who was successfully treated with 4 vessel CABG in 1997 for symptomatic disease
Summary
Our patient is a 61 year old male with a history of coronary artery disease (CAD), hypertension (HTN), and hyperlipidemia (HPL) who was successfully treated with 4 vessel CABG in 1997 for symptomatic disease. The patient presented with anginal chest pain to an outside facility in March of 2007 and was found to have a NSTEMI with a troponin peak of 16.7. He was treated medically with integrillin, plavix, aspirin, and lovenox with resolution of symptoms and laboratory abnormalities, and transferred to our center for definitive evaluation and therapy. The 12-lead ECG performed in the clinic revealed borderline right atrial hypertrophy and no evidence of ischemia or prior infarction with a normal sinus rhythm.
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