Saphenous Vein Graft Pseudoaneurysm Research Articles

Images in Vascular Medicine: Heart-shaped saphenous vein graft pseudoaneurysm - Endovascular repair with covered stent.

Images in Vascular Medicine: Heart-shaped saphenous vein graft pseudoaneurysm - Endovascular repair with covered stent.

Giant Saphenous Vein Graft Pseudoaneurysm and Total Arterial Redo Coronary Revascularization in A High-Risk Patient

Giant Saphenous Vein Graft Pseudoaneurysm and Total Arterial Redo Coronary Revascularization in A High-Risk Patient

Just Another Acute Chest Pain? Case of Contained Rupture of a Saphenous Venous Graft Pseudo-Aneurysm Mimicking Acute Coronary Syndrome

Rupture of a saphenous vein graft (SVG) pseudo-aneurysm presenting as a non-ST elevation myocardial infarction is a rarely reported, but serious complication of prior coronary artery bypass graft surgery. We present a case of a 76-year-old man who presented with severe chest pain and elevated cardiac biomarkers, and was found to have a contained pseudo-aneurysm rupture at the site of anastomosis of a 15-year SVG with the ascending aorta requiring surgical repair. We also review presenting symptoms, the current literature and treatment approaches for SVG pseudo-aneurysm. J Med Cases. 2017;8(1):17-19 doi: https://doi.org/10.14740/jmc2705w

TCTAP C-144 Successful Delivery a Covered Stent Across Saphenous Vein Graft Pseudo-aneurysm with Tortuous Anatomy Using Child Support Catheter (The GuideLiner)

### Patient initials or identifier number H.H. ### Relevant clinical history and physical exam A 70-year-old man presented on August 17, 2015 with chest discomfort. He had a history of hypertension, hypercholesterolemia and status post CABG in 2005. He had a LIMA (left internal mammary artery) to

Saphenous Vein Graft Pseudoaneurysm Causing True Chest Pain

Saphenous Vein Graft Pseudoaneurysm Causing True Chest Pain New onset of chest pain or angina after coronary artery bypass grafting (CABG) is not always related to progression of coronary disease or bypass graft failure especially saphenous vein graft aneurysm or pseudoaneurysm. Combination of imaging modalities including Chest X ray, Echocardiogram (transthoracic or transesophageal) Cardiac CT angiography (CTA), Cardiac magnetic resonance imaging (MRI) with Coronary angiographyis the main stay for diagnosis. Implantation of multiple covered stents is one of the newest modality in treatment of coronary pseudoaneurysm.

Spontaneous Disappearance of a Saphenous Vein Graft Pseudoaneurysm After Coronary Artery Bypass Grafting

A saphenous vein graft pseudoaneurysm is a rare complication of coronary artery bypass grafting. Its natural course is largely unknown because there have been few observational studies of medically observed patients. We herein report a case of spontaneous regression of a saphenous vein graft pseudoaneurysm in the early postoperative period, which has never been described, to our knowledge, in the previous literature.

Managing coronary artery vein bypass graft stump pseudoaneurysm: a novel approach

We present a case of a pseudoaneurysm of the saphenous vein graft stump, which was managed with percutaneous thrombin injection. Aneurysms of a saphenous vein coronary bypass graft are rare and aneurysms of a bypass graft stump are even rarer. To our knowledge this is the first reported case of a pseudoaneurysm of a graft stump with the use of thrombin to treat a saphenous vein graft pseudoaneurysm.

Pseudoaneurysms of the Heart

Case 1 : An 85-year-old man with a history of ischemic cardiomyopathy and recent reoperation coronary bypass surgery was noted on a routine follow-up echocardiogram to have a 25×25-mm fluid-filled extracardiac mass adjacent to the basal inferolateral wall of the left ventricle (Figure 1). Cardiac computed tomography (CT) identified the structure to be a pseudoaneurysm of a saphenous vein graft to an obtuse marginal branch of the left circumflex coronary artery. How should this patient be managed? Figure 1. Saphenous vein graft (SVG) pseudoaneurysm in an 85-year-old man after recent reoperation coronary artery bypass surgery. The pseudoaneurysm was visible as a mass (arrow) in the left atrioventricular (AV) groove on the chest x-ray ( A ). Transthoracic echocardiography ( B ) demonstrated a vascular mass (arrow) adjacent to the basal lateral wall. Cardiac computed tomographic angiography ( C ) demonstrated the pseudoaneurysm (arrow) connecting to the SVG by a narrow neck with contrast enhancement (light gray) and some thrombus (dark gray). Four-chamber view ( D ) demonstrating the pseudoaneurysm (arrow) in the left AV groove; a magnified view ( D , inset) demonstrates the pseudoaneurysm connected to the SVG via a narrow neck (arrow) with active contrast extravasation (red outline) contained by thrombus (white outline). Invasive angiography showing contrast extravasation ( E ) into the pseudoaneurysm (arrow) and postintervention angiogram demonstrated successful occlusion of the pseudoaneurysm ( F ). LA indicates left atrium; LV, left ventricle. Case 2 : A 27-year old man with prior homograft aortic valve replacement developed recurrent endocarditis (Figure 2). Echocardiography noted a periaortic valvular fluid collection concerning for abscess or valvular dehiscence. However, Doppler signal to and from the fluid collection connecting to the left ventricular outflow tract also raised concern for pseudoaneurysm. Cardiac CT confirmed the structure to be a 37×32-mm pseudoaneurysm involving the left coronary cusp of a trileaflet homograft prosthetic aortic valve just below the takeoff of …

Giant saphenous vein graft pseudoaneurysm: treatment with a vascular occlusion device

We report the case of a 74-year old male who was evaluated for progressively enlarging right heart border on serial chest radiographs. Computed tomography of the chest revealed a pseudoaneurysm arising from the saphenous vein graft (SVG) to the posterior descending artery with mass effect on the right atrium. Coronary angiography showed severely compromised distal flow and an angiographically small territory at risk. Using a minimally invasive, catheter-based approach, an Amplatzer Vascular Plug II occlusion device was utilized successfully for embolizing the SVG pseudoaneurysm.

Covered stent implantation for giant saphenous vein graft pseudoaneurysms

Saphenous vein graft (SVG) pseudoaneurysm after coronary artery bypass graft surgery (CABG) remains an uncommon and usually late complication in b5% of cases [1]. Patients can present with chest pain, dyspnea and associated compression from the mediastinal mass [2]. Treatments such as surgical repair and percutaneous coronary intervention (PCI) are not well defined. Vascular plug and coils as well as covered stents are options for treatment [3]. Options are limited for SVG pseudoaneurysms where there are multiple necks present that are poorly visualized and where prior stenting has been performed. We describe a case of where multiple Graftmaster® PTFE covered stents (Abbott Vascular) were used for a large SVG pseudoaneurysm with multiple necks. An 81-year-old woman with hypertension, hyperlipidemia, and endovascular abdominal aortic aneurysm repair, as well as CABG and prior native vessel and SVG PCI, described typical chest pain, shortness of breath and was noted to have a mediastinal mass on routine chest X-ray. She had undergone CABG in 1993 (left internal mammary artery to the first diagonal branch and SVG to the first obtuse marginal branch (OM1)), and subsequent PCI in 2000 (stent placement in the SVG to OM with three self-expanding Wallstents® (Boston Scientific, Natick, MA)) for an acute coronary syndrome. She underwent diagnostic cardiac catheterization 1 year later for

Giant Saphenous Vein Graft Pseudoaneurysm Compressing the Right Atrium and Right Ventricle and Presenting as Decompensated Heart Failure

Giant Saphenous Vein Graft Pseudoaneurysm Compressing the Right Atrium and Right Ventricle and Presenting as Decompensated Heart Failure Bartosz Hudzik, MD, Jan Glowacki, MD, PhD, Janusz Szkodzinski, MD, PhD, Jaroslaw Wasilewski, MD, PhD, Aleksandra Majsnerowska, MD, PhD, and Lech Polonski, MD, PhD a Third Department of Cardiology, Silesian Center for Heart Disease, Zabrze, Poland b Computed Tomography Laboratory, Silesian Center for Heart Disease, Zabrze, Poland

Giant Saphenous Vein Graft Pseudoaneurysm Causing Tricuspid Valve Stenosis

We present the case of a 72-year-old male who was diagnosed with a saphenous vein graft pseudoaneurysm, detected on routine chest echocardiogram 13 years after undergoing coronary artery bypass graft surgery. Intraoperative transesophageal echocardiography revealed the pseudoaneurysm to be causing functional tricuspid stenosis, which was relieved after surgical excision of the mass.

Giant Saphenous Vein Graft Aneurysm Causing Left Atrial Compression and Cardiogenic Shock

Saphenous vein graft aneurysm is a rare complication of coronary artery bypass graft (CABG) surgery that is challenging to manage and is associated with catastrophic consequences. We present the case of a 72-year-old woman with prior CABG surgery who presented with chest pain and was found to have a giant saphenous vein graft pseudoaneurysm. Further evaluation revealed that a vein graft pseudoaneurysm was causing significant compression of the left atrium. The pseudoaneurysm was successfully excluded from the blood flow with a covered stent; however, despite intra-aortic balloon pump and supportive therapy, the patient succumbed to cardiogenic shock and sepsis.

Left Internal Mammary Artery Graft Decompression by Covered Stent Treatment of an Adjacent Saphenous Vein Graft Pseudoaneurysm

A 75-year-old man with a history of coronary artery bypass grafting and recent pacemaker site infection was transferred to our institution for treatment of a descending aortic pseudoaneurysm. A computed tomography scan performed upon arrival also revealed a suspected mycotic aneurysm of the

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.

Multimodality imaging of a right saphenous vein graft pseudoaneurysm

A 74-year-old man with a history that was significant for two-vessel coronary artery bypass grafting (CABG) surgery, underwent magnetic resonance cholangiopancreatography for evaluation of chronic pancreatitis. A complex cystic mass, measuring 2 cm × 2 cm was incidentally observed anterior to the right atrium on the axial T2-weighted magnetic resonance cholangiopancreatography half-Fourier acquisition single-shot turbo spin-echo (HASTE) image (Figure 1A). A subsequent transthoracic echocardiography confirmed the cystic mass, extrinsic to the right atrium, with no intracardiac communication following administration of agitated saline contrast (Figure 1B). Multidetector computed tomography identified a pseudoaneurysm of the right saphenous vein graft from previous CABG (Figure 1C). A three-dimensional, volume-rendered multidetector computed tomography image of the graft arising from the aorta and the pseudoaneurysm is shown in Figure 1D. Cardiac catheterization confirmed the presence of a discrete inlet communication into the saphenous vein graft pseudoaneurysm (Figure 1E). The patient underwent successful occlusion of the ostium of the pseudoaneurysm by a covered stent graft (JOSTENT [Abbott Laboratories, USA] 4.00 mm × 8 mm) and disappearance of the jet of contrast (Figure 1F). Figure 1) A A complex cystic mass (arrow) measuring 3 cm × 3 cm × 4 cm was incidentally observed anterior to the right atrium on the axial T2-weighted magnetic resonance cholangiopancreatography half-Fourier acquisition single-shot turbo spin-echo ... Saphenous vein graft pseudoaneurysms are a rare complication following CABG and warrant prompt recognition due to potential fatal complications (1). They are often asymptomatic, discovered as an incidental paracardiac or mediastinal mass using complementary cardiac imaging including echocardiography, computed tomography and cardiac magnetic resonance imaging (2). Although surgery has traditionally been the treatment of choice (3), percutaneous techniques such as coiled embolization or self-expanding stents are emerging alternative options (4).

Treatment of a ruptured saphenous vein graft pseudoaneurysm using a vascular plug

Saphenous vein graft pseudoaneurysm is an uncommon complication of coronary bypass grafting. Hemoptysis associated with diffuse bleeding into the lung tissue may be the initial manifestation of this condition. We report a case of a saphenous vein graft pseudoaneurysm that presented with hemoptysis and was successfully treated with a proximal vascular plug.

Right Gastroepiploic Artery Grafting for Saphenous Vein Graft Pseudoaneurysm

Saphenous vein graft pseudoaneurysms are an unusual but potentially fatal complication of coronary artery bypass grafting because of their high risk of rupture or thromboembolism. We experienced the case of a 58-year-old man with a saphenous vein graft pseudoaneurysm with a floating thrombus that had developed 17 years after the initial coronary artery bypass grafting. The prevention of thromboembolism during a surgical procedure has been crucial for this type of operation. We developed the idea of in situ revascularization using the right gastroepiploic artery under the beating heart on cardiopulmonary bypass followed by an aneurysmectomy under an arrested heart.

Off-Pump Repair of a Giant Pseudoaneurysm of a Distal Saphenous Vein Bypass Graft

Pseudoaneurysm of a saphenous vein bypass graft is a rare occurrence after coronary artery bypass grafting but may have lethal consequences. We treated a giant pseudoaneurysm of a saphenous vein graft to the right coronary artery in an 80-year-old male Jehovah's Witness who had undergone coronary artery bypass grafting 4 and a half years earlier. His history revealed a recurrent sternal wound infection. By using a venous patch to close the damaged graft, we were able to perform a successful surgical repair without the need for extracorporeal circulation.

Saphenous vein graft pseudoaneurysm: Diagnosis by transesophageal echocardiography and magnetic resonance imaging

Coronary cineangiography showed probable pseudoaneurysm formation at the origin of an 11-year-old saphenous vein coronary bypass graft. Transesophageal echocardiography and magnetic resonance imaging were helpful in differentiating this from aortic dissection or true aneurysm formation and assisted the surgeon in avoiding perforation of the pseudoaneurysm during sternotomy.