Aneurysm of saphenous vein graft to coronary artery presenting as non-Q-wave myocardial infarction secondary to mass effect.
Large aneurysms (> 4 cm) of saphenous vein grafts (SVG) to coronary arteries are a rare complication of coronary artery bypass graft surgery (CABG). A 64-year-old male, status post-CABG 14 years ago, presented with dyspnea and diaphoresis. Pneumonia and non-Q-wave myocardial infarction (MI) were diagnosed. Cardiac catheterization and chest computed tomography demonstrated a 5 x 7-cm aneurysm of a SVG. At the time of surgery, the left internal mammary artery (grafted to the left anterior descending artery) was found to be stretched tautly over the aneurysm, resulting in impaired flow. The aneurysm was successfully resected. This is the first published case implicating a SVG aneurysm as the direct cause of a MI by mass effect.
Sahouri
S J
SJ
St. Joseph Mercy Hospital, Ann Arbor, Michigan, USA.
Steele
R L
RL
D003323:Coronary Aneurysm / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D012501:Saphenous Vein / Q000637:transplantation*; D014057:Tomography, X-Ray Computed