Abstract

The authors report a 79-year old man with a history of coronary bypass surgery, presenting with acute heart failure and elevated troponin. Coronarography revealed a giant saphenous vein graft aneurysm, which was compressing the left internal mammary artery bypass graft. This was confirmed by a multislice enhanced-ECG gated cardiac CT, showing the venous aneurysm responsible for external compression of the arterial graft and its functional occlusion. Myocardial ischaemia, the mechanism leading to cardiac failure, was confirmed by hypoperfusion of the sub-endocardial area shown by the CT. The aneurysm was surgically removed without complications. The patient recovered and his cardiac function improved. This is the first recorded case of compression of the left internal mammary artery by an giant saphenous vein graft aneurysm having triggered severe myocardial ischaemia and heart failure. The authors review the incidence and complications of giant venous bypass graft aneurysms reported in the literature.

Links

Publisher Full Text

Authors

Van Caenegem O, le Polain de Waroux JB, de Kerchove L, Coche E

Institution

Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Belgium. olivier.vancaenegem@uclouvain.be

Source

Interactive cardiovascular and thoracic surgery 15:3 2012 Sep pg 540-1

MeSH

Aged
Coronary Aneurysm
Coronary Angiography
Coronary Artery Disease
Electrocardiography
Heart Failure
Humans
Internal Mammary-Coronary Artery Anastomosis
Male
Myocardial Ischemia
Prosthesis Failure
Saphenous Vein
Tomography, X-Ray Computed

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

22723090