Abstract
Aneurysms of saphenous vein grafts (SVGs) to coronary arteries are rare, usually asymptomatic and found incidentally. We report a case of an 84-year-old female who was found to have 8.1 × 8.4 cm aneurysm of an SVG to obtuse marginal (OM) artery. The aneurysm was prior to the distal anastamosis but no flow into the OM artery was noted. Cook Tornado Embolization Coils were used successfully to occlude the SVG proximal to the aneurysm. No complications occurred. The use of embolization coils is an effective and safe method for aneurysm occlusion when the anatomy is suitable and especially when patient is high risk for repeat surgical intervention.
Highlights
Aneurysms of aortocoronary saphenous bypass grafts (SVGs) are an unusual complication
We report a case of a large aneurysm of SVG to obtuse marginal artery which was successfully treated with percutaneous coil embolization of the SVG
Giant SVG aneurysm is defined as being greater than 4 cm in diameter [5] and is a rare occurrence after aortocoronary bypass (ACB)
Summary
Aneurysms of aortocoronary saphenous bypass grafts (SVGs) are an unusual complication. The diagnosis should be considered in all patients presenting with a hilar or mediastinal mass following aortocoronary bypass (ACB), as timely treatment may avert aneurysm rupture and death. Patient had redo ACB 8 years ago with a left internal mammary artery (LIMA) to LAD, and SVG to OM, as she was found to have diffusely diseased SVG to LAD and a totally occluded SVG to OM. She was found to have a mediastinal mass on routine chest X ray which was done for evaluation of cough and fever. Aneurysm lumen filled with contrast 8.1×8.4 cm SVG aneurysm filled with thrombus
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