We report herein the case of an 80-year-old woman who underwent successful redo coronary artery bypass grafting (CABG) for a saphenous vein graft aneurysm found 10 years after her initial operation. On presentation, coronary angiography (CAG) revealed aneurysmal dilatation of the saphenous vein graft and severe stenosis of the left main trunk (LMT). A percutaneous transluminal coronary angioplasty (PTCA) of the LMT lesion was performed; however, a CAG after the PTCA revealed restenosis and the patient developed anginal chest pain at rest. Thus, repeat CABG was urgently carried out, which was followed by a good outcome. Histological examination of the aneurysmal dilatation showed a true aneurysm. Only 15 other cases of redo CABG for this indication have been reported, the features of which are also discussed.
Although there are several mitral valve aneurysm reports, studies on aortic valve aneurysm are extremely rare. This paper describes an uncommon case of a large saccular aortic valve aneurysm associated with infective endocarditis. A 37-year-old man was hospitalized in our hospital with fever and dyspnea. Echocardiography found severe aortic regurgitation and aortic valve aneurysm of the non-coronary cusp going in and out of the left ventricular chamber. Blood cultures grew Streptococcus viridance. Therefore, the patient underwent aortic valve replacement. During the operation, we observed a 30 × 20 mm ruptured aneurysm that arose from the non-coronary cusp. The aortic valve containing the aneurysm was resected and replaced with a mechanical heart valve. Histopathological examination of the aortic valve aneurysm showed active inflammatory changes. Infective endocarditis was considered to be the cause of this aortic valve aneurysm.
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