Giant aneurysm of an aortocoronary venous bypass graft compressing the right ventricle

Case report: Unusual presentation of haemopericardium with haemodynamic instability secondary to a coronary graft pseudoaneurysm treated by an endovascular approach

Background

Case summary

Discussion

Giant Saphenous Venous Graft Aneurysm with Compression of the Pulmonary Artery: A Rare Cause of Heart Failure

We report a case of a 74-year-old man who presented with dyspnea on exertion and pedal edema. He had five-vessel coronary artery bypass graft (CABG) surgery twenty-six years ago and redo three-vessel CABG done thirteen years later. Computed tomographic angiography (CTA) of the heart and coronary vessels demonstrated a giant aneurysm arising from the saphenous venous graft (SVG) to the first obtuse marginal of the left circumflex artery compressing the pulmonary artery (PA). He underwent coronary angiography, confirming the CTA findings. Surgical and percutaneous interventions were offered, but the patient opted for conservative management due to the high risk of morbidity and mortality.

A giant saphenous vein graft aneurysm causing left internal mammary artery to left anterior descending artery graft compression

Saphenous vein graft aneurysm is a rare complication after coronary artery bypass surgery. It is defined as a localized dilatation of the vessel to 1.5× the expected normal diameter. We report a case of 67-year-old man who presented with angina 23 years after coronary artery bypass graft. He was found to have a giant saphenous vein graft aneurysm to diagonal artery compressing the left internal mammary artery graft to the left anterior descending artery. The patient underwent aneurysm resection with satisfactory outcome.

Giant aneurysm of an aortocoronary venous bypass graft compressing the right ventricle

A 69-year-old man with a history of coronary artery bypass grafting and a recent inferoposterior myocardial infarction presented to the hospital for diagnostic coronary angiography. Physical examination, laboratory analyses, coronary angiography, echocardiography, and CT scan were performed. A giant aneurysm of the aortocoronary venous bypass graft, associated with compression of the right side of the heart, was revealed. After surgical resection and replacement of the venous graft the patient died due to right ventricular failure. (Neth Heart J 2007;15:252-4.Neth Heart J 2007;15:252-4.).

Tandem aneurysms of an internal mammary-aortocoronary bypass graft

Graft aneurysms following aortocoronary surgery are a rare occurrence in clinical practice. Reported cases have mostly involved saphenous vein grafts. Here we report the rare finding of a tandem aneurysm of an internal mammary artery graft which was incidentally detected 17 years following bypass surgery. (Neth Heart J 2009;17:300-2.).