Saphenous Vein Graft Aneurysm Research Articles

Percutaneous Closure of Giant Saphenous Vein Graft Aneurysm

A 78-year-old man was referred to our institution for treatment of an unusual expanding aneurysm. There was a history of prior coronary artery bypass surgery in 1999. Subsequently, he had developed exertional dyspnea, and chest X-rays demonstrated a right chest mass that was increasing in size.

Saphenous Vein Graft Aneurysm After Renal Transplantation: A Case Report

Saphenous Vein Graft Aneurysm After Renal Transplantation: A Case Report

Saphenous vein graft aneurysm

A 64-year-old Caucasian man with a history of hypertension, diabetes, Raynaud’s phenomenon and coronary artery bypass grafting presented with chest pain and syncope. The echocardiogram revealed an extracardiac mass (arrow) with compression of the atrium (Figure 1). The cardiac computed tomographic angiogram revealed an 8 cm right coronary artery saphenous vein graft (SVG) aneurysm that was occluded in its mid segment (Figure 2). The aneurysm was lined with thrombus. The coronary angiogram confirmed the above findings (Figure 3). The patient subsequently underwent resection of the aneurysm, reconstruction of the right atrial wall and redo saphenous vein bypass graft to the right coronary artery. He did well postoperatively. Figure 1) LV Left ventricle; RV Right ventricle Figure 2 Figure 3

Multimodality imaging in the management of aorto-coronary saphenous vein graft aneurysm

Fig. 1. (a) TOE, modified bicaval view, demonstrates a ‘mass’ in close association to the right atrium (white arrow), (b) TruFISP cardiac magnetic resonance demonstrates that the aneurysm (white arrow) has a perfused central lumen and there was perfusion of the distal right coronary artery, (c) multislice CT demonstrates a grossly aneurysmal saphenous vein graft with a large amount of mural thrombus supplying the distal right coronary artery. Ao: aorta; CS: coronary sinus; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle; Th: mural thrombus; white arrow: aneurysm.

Surgical Treatment of Saphenous Vein Graft Aneurysms After Coronary Artery Revascularization

Saphenous vein graft (SVG) aneurysms (SVGAs) after coronary artery bypass grafting (CABG) occur rarely. Most reports are anecdotal. To determine early and late outcomes of surgical treatment, we reviewed our experience with management of this rare complication of surgical revascularization. From July 1975 to October 2007, 16 patients (15 men), mean age, 60.9 +/- 14.6 years, underwent repair of aortocoronary SVGAs. Chest pain was present in 11 of 16 patients. The rest were asymptomatic. The average maximum diameter of the SVGA was 64 +/- 30 mm. The concern of SVGA rupture was the primary indication for operation in 9 patients (56%). Repair in the remaining patients occurred during other cardiac operations. A pseudoaneurysm (75%) at the body or anastomotic sites of the SVG was the most common cause of SVGA. In 8 patients (50%), the aneurysm involved SVG anastomotic sites. Thirteen patients (81%) had intraluminal thrombi. Vein grafts with aneurysm were patent in 9 patients (56%). Surgical procedures included excision of the aneurysm and direct distal coronary target vessel revascularization in 10 (63%), excision and interposition vein graft in 5 (31%), and exclusion by ligation in 1 (6%). Median follow-up was 7 years (maximum, 20 years). Survival was 83% at 5 years and 72% at 10 years after SVGA repair. Ischemic symptoms often accompany SVGA, and operation is indicated to prevent rupture. Ligation or excision of SVGA with simultaneous revascularization appears to be the optimal therapy, with satisfactory midterm and long-term results.

A large saphenous vein graft aneurysm one year after coronary artery bypass graft surgery presenting as a left lung mass

Aneurysm of a saphenous vein graft (SVG) is a rare but fatal complication of coronary artery bypass graft (CABG) surgery. The development of SVG aneurysms appears usually about 10-20 years after the operation at an estimated rate of <1%. A 68-year-old male was referred to the emergency department after frequent episodes of dyspnea, chest pain and hemoptysis. He previously had CABG surgery one year before. The physical examination was normal. Chest radiogram showed a left pulmonary midzone mass. CT-angiogram demonstrated a large aortic pseudoaneurysm (6.36 x 6.06 cm) in the middle part of the ascending aorta. After sternotomy, the ascending aorta above sinotubular junction near the origin of brachiocephalic artery was resected and replaced with a tube graft. The patient was transferred to ICU with stable hemodynamic status. SVG aneurysm should be considered while encountering mediastinal mass or undiagnosed cardiopulmonary symptoms in patients with a previous history of CABG because of its rarity and overlap of symptoms with other thoracic, pulmonary, and cardiac diseases. Surgery seems to be the treatment of choice to reduce the risk of rupture and embolism.

Novel Treatment of an 11-cm Saphenous Vein Graft Aneurysm

Saphenous vein graft pseudoaneurysms are rare and potentially fatal complications after coronary artery bypass graft surgery. Here we present an 11-cm saphenous vein graft pseudoaneurysm from a 20-year-old vein graft to the obtuse marginal artery. The pseudoaneurysm was directly located beneath the sternum and adjacent to two patent grafts. Therefore, we used a novel approach to access the aorta through a right thoracotomy, and using a pericardial patch, we closed the ostia to the pseudoaneurysm. Postoperatively there was no longer flow into the aneurysm, and at 1-year follow-up the patient is doing well.

Acute chest pain due to ruptured giant aortocoronary saphenous vein graft aneurysm

A 66-year-old man suddenly felt an intense acute chest pain with posterior irradiation, associated with shortness of breath. His medical history was remarkable for hypertension, hypercholesterolemia and smoking. He underwent quadruple coronary artery bypass graft surgery 17 years previously, consisting of three sequential grafts made with the same saphenous vein, and one arterial graft on the left anterior descending artery. The initial workup ruled out acute coronary syndrome; therefore, a thoracic computed tomography (CT) scan was performed. The CT scan revealed an enormous hematoma on the right side of the heart with a diameter of 57 mm × 48 mm, filled with contrast dye and compressing the right heart cavities with signs of pericardial suffusion (Figure 1A). Three-dimensional image reconstruction showed large aneurysms originating from the saphenous vein graft (Figure 1B). The image only presented the area filled with contrast medium, so only the true lumen of the aneurysm was visible. Coronary bypass angiography confirmed the presence of a large aneurysm that arose from the proximal and midportion of the sequential saphenous vein graft (Figure 1C). Figure 1) A Computed tomography scan revealing an enormous hematoma on the right side of the heart with a diameter of 57 mm × 48 mm (red arrows), filled with contrast dye and compressing the right heart cavities with signs of pericardial suffusion. B Three-dimensional ... Rupture of vein graft aneurysms remains a rare complication; there are only a few reported cases (1,2). The present patient presented with a life-threatening condition with concealed rupture and underwent successful repeat coronary artery bypass graft surgery to the inflamed tissue. A CT scan should be performed to rule out this diagnosis in bypassed patients with unexplained chest pain.

Percutaneous Management of a Long Saphenous Vein Graft Aneurysm: A Case Report and Review of Literature

Aneurysms of saphenous vein grafts are rare but can result in complications such as myocardial infarction or death. Percutaneous treatment has included a variety of approaches, including covered stents. Long aneurysms in saphenous vein grafts pose an additional challenge due to the lack of coronary covered stents with sufficient length. We present successful treatment of a long saphenous vein graft aneurysm with use of peripheral covered stents over two coronary guidewires, a 55-centimeter 8-French sheath and no guide catheter.

Graft aneurysm complicating an extracranial-intracranial bypass

We report a patient that developed an aneurysm on a grafted saphenous vein following an extracranial-intracranial (EC-IC) bypass. Although saphenous vein graft aneurysms (SVGAs) have been described as a rare complication following coronary surgery, we are unaware of any previously reported cases of SVGAs following EC-IC bypass.

Closure of a Giant Saphenous Vein Graft Aneurysm with Embolization Coil

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.

Aneurysm of an autologous aorta to right coronary artery reverse saphenous vein graft presenting as a mediastinal mass: a case report

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.

Covered Perforated Aortocoronary Saphenous Vein Graft Aneurysm

We report a case of a 75-year-old man suffering from a covered perforated aneurysm of a saphenous bypass graft to the right coronary artery (RCA) constructed 22 years ago. Additional complete revascularization had been performed in 2001. A thoracic computed tomography scan for evaluation of fever of unknown origin had revealed a huge hematoma in front of the right heart. Coronary angiography showed open bypasses but an irregular-shaped aneurysm of the venous graft to the RCA right before the distal anastomosis. Occurrence of a new right-sided pleural effusion led to the emergent operation since rupture of the aneurysm and drainage into the pleura was likely. A massive precordial hematoma was found and the existence of the perforated aneurysm could be confirmed. After institution of cardiopulmonary bypass the graft was resected. Since the patient had a functioning bypass to the RIVP, there was no need for additional revascularization. The patient underwent an uneventful postoperative course.

Saphenous vein graft aneurysm with graft-enteric fistula after renal artery bypass

A 65-year-old female presented with upper gastrointestinal hemorrhage thirty years following an aorta-to-right renal artery bypass constructed with saphenous vein. Upper endoscopy demonstrated a duodenal ulcer, and a CAT scan demonstrated aneurysmal degeneration of her renal artery bypass with duodenal impingement. Laparotomy demonstrated erosion of the aneurysm through the posterior wall of the duodenum; extra-anatomic renovascular reconstruction and primary duodenal repair was performed. Although aneurysmal degeneration of intraabdominal saphenous vein grafts is well described and rupture likewise reported, this report represents the first description of an intraabdominal autogenous vein graft aneurysm presenting with gastrointestinal erosion and fistula.

Occlusion of a Giant Saphenous Vein Graft Aneurysm Using Distal Coil Embolisation and a Proximal Vascular Plug

An asymptomatic giant true saphenous vein graft aneurysm was successfully occluded by percutaneous distal coil embolisation combined with deployment of a proximal Amplatzer vascular occlusion plug. The aneurysm cavity was excluded from both antegrade flow via the aortosaphenous anastamosis and retrograde flow via the distal left anterior descending coronary artery (supplied by a left internal mammary artery graft), to reduce the risk of subsequent aneurysm rupture.

Percutaneous closure of a saphenous vein graft aneurysm being at risk for rupture

Percutaneous closure of a saphenous vein graft aneurysm being at risk for rupture

Giant Saphenous Vein Graft Pseudoaneurysm Rupture Presenting with Cardiac Tamponade

Saphenous vein graft aneurysms are a rare but potentially fatal complication following coronary artery bypass graft (CABG) surgery, with a wide variation in clinical presentations ranging from recurrent atypical chest pain to sudden cardiac death. Although uncommon, the diagnosis should be considered in all patients presenting with a hilar or mediastinal mass following CABG, as timely treatment may avert potentially fatal aneurysm rupture and death. We report a rare case of a giant vein graft pseudoaneurysm rupture causing cardiac tamponade.

Saphenous Vein Graft Aneurysm Masquerading as a Left Atrial Mass: Diagnosis by Contrast Transesophageal Echocardiography

We describe the first reported case of a saphenous vein graft aneurysm mimicking a left atrial (LA) mass on echocardiographic imaging in a 62-year-old man 22 years after coronary bypass surgery. On presentation with worsening angina, a transthoracic echocardiogram revealed a LA mass. Coronary angiography showed severe native coronary artery and graft disease. The saphenous vein graft to the first obtuse marginal branch of the left circumflex coronary artery appeared ectatic and aneurysmal and was diffusely diseased. Transesophageal echocardiography demonstrated a well-circumscribed mass apparently within the LA, with an area of central echolucency and a surrounding crescentic region of increased echodensity, with absent flow by color and spectral Doppler techniques. After an intravenous bolus injection of Definity, the area of central echolucency within the mass was opacified compatible with a vascular origin. Pulsatile contrast flow was seen predominantly in diastole consistent with a coronary arterial flow pattern. Thus, contrast transesophageal echocardiography confirmed the diagnosis of a saphenous vein graft aneurysm invaginating the lateral aspect of the LA, mimicking a true LA mass, highlighting a novel use for this technology.

Cardiac tamponade caused by a leaking coronary saphenous vein graft aneurysm

Cardiac tamponade caused by a leaking coronary saphenous vein graft aneurysm

Aneurismas múltiplos de pontes aorto-coronárias de veia safena com ruptura fatal

Aortocoronary saphenous vein graft (SVG) aneurysms are rare, and are usually asymptomatic and detected incidentally. Spontaneous rupture of SVG is rare and imaging data are few. We report on a 39-year old man who was admitted to the hospital with hematemesis 10 years after aortocoronary bypass surgery. CT images revealed 3 aortocoronary SVG aneurysms, but failed to detect any rupture. His subsequent death due to rupture of SVG aneurysm was documented at autopsy, illustrating the need for aggressive treatment of symptomatic coronary graft aneurysms.