Large Saphenous Vein Graft Aneurysm Research Articles

Percutaneous transcatheter closure of a large saphenous vein graft aneurysm with Amplatzer vascular plug

A saphenous vein graft (SVG) aneurysm is a rare complication seen in coronary artery bypass grafts (CABG). While the sternotomy for surgical correction is used in most of these patients, depending on the patient’s condition, an alternative method may be required. This case is a 64-year-old man who developed SVG aneurysm more than 10 years after CABG and underwent a successful percutaneous transcatheter exclusion of SVG aneurysm using 10 mm Amplatzer Vascular Plug 2, resulting in prevention of blood flow into the aneurysm and future rupturing. This case illustrates the potential of noninvasive treatment with flexible procedures based on the patient’s anatomy and risk for complicated surgery. Keywords: Amplatzer vascular plug, saphenous vein graft, saphenous vein graft aneurysm, coronary artery bypass graft

冠動脈バイパス術後15年に発見された巨大な大伏在静脈グラフト瘤の1手術例

今回われわれは，15年前に使用した静脈グラフトの瘤化により再バイパス術を施行し，良好な結果を得た症例を経験したので報告する．57歳の女性，他院で右冠動脈に大伏在静脈を用いた計4本の冠動脈バイパス術を施行しており，今回，偶然に胸部レントゲン写真で異常陰影を指摘されて精査を行い，大伏在静脈瘤と診断した．術前の検査で，グラフトは小伏在静脈のみ使用可能であった．オフポンプで右冠動脈にバイパスを作成し，瘤化したグラフトは切除した．術後経過は問題なく退院となった．組織所見は動脈硬化性変化を認め，全身性エリテマトーデスによるステロイドの長期内服と慢性透析，喫煙などのリスクファクターが原因と考えられた．

Stent-graft repair of a giant saphenous vein graft aneurysm

Saphenous vein graft aneurysms are an uncommon late complication of coronary artery bypass surgery (CABG). Management strategies include surgical revision, percutaneous closure using covered stent grafts, coil embolisation, vascular plug insertion and ethylene vinyl alcohol copolymer injection. We report a case of a very large saphenous vein graft aneurysm successfully treated with a covered stent graft.

Re: Thrombosis of a large saphenous vein graft aneurysm leading to acute myocardial infarction 21 years after coronary artery bypass grafting: role of cardiac multi-slice computed tomography

Re: Thrombosis of a large saphenous vein graft aneurysm leading to acute myocardial infarction 21 years after coronary artery bypass grafting: role of cardiac multi-slice computed tomography

Thrombosis of a large saphenous vein graft aneurysm leading to acute myocardial infarction 21 years after coronary artery bypass grafting: role of cardiac multi-slice computed tomography

We report a case of a 74-year-old male, who presented with an acute ST elevation posterior wall myocardial infarction (MI) 21 years following revascularization with three saphenous vein grafts (SVGs) to the left and right coronary arteries. In coronary angiography (CAG), the dilated SVG to the first marginal branch of the circumflex artery appeared only contrast enhanced in the proximal portion. The day after coronary angiography 128-slice cardiac computed tomography (CT) was performed. Cardiac CT showed a 5×3-cm incomplete thrombosed aneurysm of the proximal bypass with complete thrombotic occlusion of distal bypass grafting. With this diagnosis the patient was referred to a cardiothoracic unit for a second opinion. A surgical intervention was refused due to an increased intraoperative morbidity and occlusion of peripheral bypass portion. A follow-up CAG 10days after infarction showed complete occlusion of the aneurysm. This case illustrates the utility of multi-slice CT to diagnose SVG aneurysm and influence clinical decisions for further treatment. This is the first report of a spontaneous SVG aneurysm thrombosis under a conservative treatment approach with recovery of the patient after MI. Clinical follow-up five months after infarction was unremarkable.

Saphenous Vein Graft Aneurysm After Renal Transplantation: A Case Report

Saphenous Vein Graft Aneurysm After Renal Transplantation: A Case Report

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.

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.

A Large Saphenous Vein Graft Aneurysm Presenting as a Right Atrial Mass: A Case Report

An aneurysm of a saphenous vein graft (SVG) is a rare but potentially fatal complication of coronary artery bypass grafting (CABG). We describe a case of a large SVG aneurysm (7 x 6 cm) compressing the right atrium. The patient presented with chest pain, dyspnea and desaturation, and a right intra-atrial mass was revealed on echocardiography. The differential diagnosis of intracardiac masses revealed by echocardiography should include extrinsic lesions. Due to its potential lethal complications, an SVG aneurysm should be considered in a post-CABG patient presenting with acute coronary syndrome or heart failure.

Percutaneous Treatment of a Large Vein Graft Aneurysm With Covered and Conventional Stents

A 75-year-old man presented with typical angina 13 years after coronary artery bypass grafting. Angiography demonstrated a patent internal mammary graft to the left anterior descending artery and vein graft to the obtuse marginal branch of the left circumflex artery. The large-caliber right coronary graft had a large false aneurysm in its midportion, at the site of a severe stenosis. The aneurysm …

Echocardiographic diagnosis of an asymptomatic aneurysm of a saphenous vein graft

A case of a 73-year-old asymptomatic man with a large saphenous vein graft aneurysm first diagnosed 16 years after bypass operation is presented. The lesion was first suspected on routine transthoracic echocardiography and further clarified by transesophageal echocardiography. Selective graft angiography confirmed the diagnosis and surgical therapy included resection of the graft aneurysm and coronary artery bypass grafting. (J Am Soc Echocardiogr 2002;15:661-4.)

Saphenous vein graft aneurysm presenting as a large mediastinal mass compressing the right atrium

In summary, a patient with a large saphenous vein graft aneurysm is described. This case illustrates the role of magnetic resonance imaging and cardiac catheterization in patients with a mediastinal mass and a history of coronary bypass surgery.