Aneurysms of an Aorto-Coronary Artery Saphenous Vein Bypass Graft—A Case Report

Abstract

A 62 year old man with severe angina pectoris underwent aoroto-coronary saphenous vein graft implantation. After a four month asymptomatic period the patient underwent aorto-coronary graft angiography. Left anterior descending graft opacification demonstrated multiple venous aneurysmal dilations. The clinical significance of this finding is currently unknown but such saphenous vein disease warrants further investigation. Saphenous vein grafts have been utilized to replace or bypass obstructed and diseased peripheral arteries such as those of the carotid and femoral-popliteal vascular systesm. In 1967 Favaloro introduced the saphenous vein as a means for bypassing local obstructions in diseased coronary arteries of human subjects. Since the advent of the aorto-coronary saphenous vein bypass graft procedure several studies have reported pathologic alterations of these grafts at post-mortem examination or at the time of re-operation. Other investigators have also noted changes in these venous grafts when they have been implanted in peripheral vessels. We report here a patient with aneruysmal dilations of an aorto-coronary artery saphenous vein bypass graft. Furthermore, possible mechanisms which might produce such venous aneurysms and the clinical significance of such an entity are discussed.

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

“…Our literature review identified 107 patients [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95]. The demographic, clinical and pathological features are summarized in ...…”

Aneurysms of saphenous vein grafts as late complication of coronary artery bypass surgery: successful exclusion by percutaneous transcatheter embolization

“…Cases of SVG aneurysms have been reported since 1975 [17,18]. Saphenous vein graft aneurysms are often asymptomatic, even when their diameters are large, as in such 10-cm SVG aneurysm reported by Wight et al [19]; however, aneurysm rupture is not exceptional [11,12,13] and SVG aneurysm infection has been reported as well [20].…”

Saphenous Vein Graft Aneurysm Presenting as Abdominal Pain

“…The few cases of early presentation of SVG aneurysm are attributed to an inherent weakness of the venous wall due to lack of circular muscle at the site of venous valves. 4 The cause of late-developing aneurysms is incompletely understood but believed to involve developing atherosclerosis and thrombus, 5,6 hyperlipidemia, 6 hypertension, as well as defects to the vein graft itself, 5 and trauma. 7 SVG aneurysms are often asymptomatic and many times are suspected because of an unusual chest x-ray.…”