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Ann Thorac Surg 1999;68:1433-1437
© 1999 The Society of Thoracic Surgeons

Current Reviews

Giant aneurysm of saphenous vein graft to coronary artery compressing the right atrium

Robert Kalimi, MDa, Robert S. Palazzo, MDa, L. Michael Graver, MDa

a Division of Cardiothoracic Surgery, Department of Surgery, Long Island Jewish Medical Center, New Hyde Park, New York, USA

Address reprint requests to Dr Kalimi, Department of Surgery, Long Island Jewish Medical Center, 270-05 76th Ave, New Hyde Park, NY 11040

Aneurysm of reverse aortocoronary saphenous vein graft is a known complication of coronary artery bypass grafting. In this report we present a case of a 60-year-old man who presented 12 years after coronary artery bypass grafting with a giant graft aneurysm of the reverse aortocoronary saphenous vein graft to the right coronary artery, compressing the right atrium. Spiral computed tomography was used to identify the aneurysm measuring 7 x 6 x 7 cm. We also reviewed the English-language literature and found reports of 50 patients with similar aneurysms of which 30 (61%) were identified as true aneurysms and 17 (33%) were identified as pseudoaneurysms. Three patients could not be identified into either group. We reviewed the presenting symptoms, diagnostic tools, and treatment options for this rare entity. An understanding of the pathophysiology of reverse aortocoronary saphenous vein graft aneurysm is important to prevent the possibility of aneurysm rupture, embolization, myocardial infarction, or death.




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