Dehiscence of infected aortocoronary vein graft suture lines. Cause of late pseudoaneurysm of ascending aorta.

Abstract

Two cases are described of late pseudoaneurysm of the ascending aorta caused by dehiscence of infected aortocoronary vein graft suture lines. Both cases were associated with early postoperative Staphylococcus aureus superficial wound infection. This complication should be suspected in patients developing protracted wound infections after operation, particularly when associated with rigors.

Acute Myocardial Infarction and Severe Prosthetic Dysfunction after Bentall Procedure

“…Regarding the etiologies related to this unusual finding, infection of aortocoronary vein graft suture lines is the most common cause of this condition and some cases may be associated with early postoperative Staphylococcus aureus superficial wound infection. In this case, the patient presented with late clinical features several years after the surgical procedure; and the anatomopathological examination 7 , 8 revealed no signs of infection in the aorta specimen and Dacron prosthesis ( Figure 2B ).…”

Pulmonary outflow stenosis due to saphenous vein graft aneurysm: a rare case report and review of literature

“…Furthermore, it lacks an intimal layer, as it arises from disruption between the media and adventitia [9]. Pseudoaneurysms seen in grafts mainly occur at suture lines, and are most often due to breakage of a suture, dehiscence of a suture line or by infections that are either direct or that are hematogenous seed to the anastomotic sites at the proximal or distal ends of the vein graft [10][11][12]. Due to such pathophysiology, pseudoaneuryms are commonly seen as an acute finding whereas true aneuryms caused by atherosclerosis, are more subclinical and chronic in nature.…”

Saphenous vein graft aneurysms; the true, false and ugly!

“…Non-reversal of the SVG has been proposed as a mechanism of multiple true aneurysms, but this is not supported by the extensive literature looking at patency of reversed versus non-reversed/in situ vein grafts for infrainguinal bypass surgery [2,5]. Pseudoaneurysm formation occurs mainly at suture lines whether due to breakage of a suture, dehiscence of a suture line or infection [6]. Weakness of a branch site with subsequent rupture may produce a pseudoaneurysm in the mid portion of a graft.…”