Anterior Mediastinal Mass in a Patient With Prior Saphenous Vein Coronary Artery Bypass Grafting

Trop, Isabelle; Samson, Louise; Cordeau, Marie-Pierre; Leblanc, Pierre; Thérasse, Éric

doi:10.1378/chest.115.2.572

Cited by 26 publications

(10 citation statements)

References 26 publications

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“…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 ...…”

Section: Resultsmentioning

confidence: 99%

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

et al. 2005

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Aneurysmal dilatation of saphenous vein graft (SVG), first reported in 1975, is secondary to true aneurysm or pseudoaneurysm. We report 1 case and review 107 cases published since 1975. Severe SVG dilatations are large (6 ± 3 cm), occur remote from surgery (12 ± 4 years) and are life threatening, with 15.7% in-hospital mortality. Symptoms are nonspecific and the abnormality is initially observed by chest X-ray in 57% of cases. The chest X-ray abnormalities have a distinctive appearance that may suggest both diagnosis and which SVG is involved. Diagnosis is made clinically by imaging, i.e. computed tomography, echocardiography, magnetic resonance and/or surgical observation (66 cases), or most accurately by tissue evaluation by the pathologist (42 cases). Aneurysm is more common than pseudoaneurysm by a 6:1 ratio.

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Section: Resultsmentioning

confidence: 99%

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

et al. 2005

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“…Most aneurysms are detected incidentally. The can present as myocardial ischaemia or infarction, fistula formation into the cardiac chambers and rupture (5).…”

Section: Resultsmentioning

confidence: 99%

Managing coronary artery vein bypass graft stump pseudoaneurysm: a novel approach

Rachapalli¹,

Evans²,

Roberts

2012

Journal of the Belgian Society of Radiology

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An 85-year-old man, with a background cardiac history of myocardial infarction and aortic stenosis, presented with a shortness of breath and central chest pain, radiating to the right arm and back. A coronary angiogram demonstrated a narrowing of the proximal right coronary artery (RCA), mid left anterior descending artery (LAD) and proximal first diagonal (D1) branch. He underwent an aortic valve replacement and three vessel bypass. The left internal mammary artery was anastomosed to the LAD, venous grafts (VG) to the D1 and RCA. He underwent emergency sternotomy 10 days later, for pericardial tamponade, which demonstrated bleeding from two sites: a slit in the VG to the D1 which was 2 cm from the aortic end and from the lateral angle of the aortotomy. The VG slit was thought to be secondary to trauma from the emergency bedside sternotomy. Post-operatively patient developed respiratory compromise, renal impairment and a sternal wound infection. Eight days later, he became hypotensive, with oozing from the sternal wound. A further sternotomy identified the source of bleeding to be from the previous site of injury to the VG. It was elected to resect the VG, as repairing it would have severely compromised the luminal diameter.Further sternal bleeding occurred 25 days after the third operation, but was haemodynamically stable. A computer tomography (CT) of the chest demonstrated a pseudoaneurysm from the aortic stump of the VG to D1 (Fig. 1A,B). Under CT guidance a spinal needle was inserted into the pseudoaneurysm sac parasternally. 1.2 mls of thrombin (Fig. 2B). Ten days after the thrombin injection, the patient developed further bleeding from the sternal wound. CT of the chest demonstrated that the pseudoaneurysm had recurred. A repeat thrombin injection was undertaken. A spinal needle was placed into the sac of the pseudowas injected ( Fig. 2A). Post procedure CT scan showed that the pseudoaneurysm had thrombosed JBR-BTR, 2012, 95: 261-262. MANAGING CORONARY ARTERY VEIN BYPASS GRAFT STUMP PSEUDO -

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“…Despite the large number of patients undergoing CABG with autologous saphenous veins, formation of false or true aneurysms of venous grafts remains uncommon: the occurrence of true aneurysms, defined as dilatations greater than 3 cm in diameter, has been reported in fewer than 30 cases in the world literature. 1,2 In 1975, Riahi et al reported the first case of aneurysm of an aortocoronary saphenous vein bypass graft. 3 Clinical presentation is variable: myocardial infarction due to distal embolization from the venous graft, angina pectoris, atypical chest pain, and the congestive heart failure.…”

Section: Discussionmentioning

confidence: 99%

Giant Aneurysm of Aortocoronary Saphenous Vein Graft Compressing the Left Pulmonary Artery

et al. 2006

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Anterior Mediastinal Mass in a Patient With Prior Saphenous Vein Coronary Artery Bypass Grafting

Cited by 26 publications

References 26 publications

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

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

Managing coronary artery vein bypass graft stump pseudoaneurysm: a novel approach

Giant Aneurysm of Aortocoronary Saphenous Vein Graft Compressing the Left Pulmonary Artery

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