Severe dilatation of saphenous vein grafts: a late complication of coronary surgery in which the diagnosis is suggested by chest x-ray.
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.
Almanaseer
Yassar
Y
Division of Cardiology, St. John Hospital and Medical Center, Detroit, Mich., USA.
Rosman
Howard S
HS
Kazmouz
Ghassan
G
Giraldo
Alvaro A
AA
Martin
James
J
D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D013902:Radiography, Thoracic; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000637:transplantation*; D012720:Severity of Illness Index; D014664:Vasodilation / Q000502:physiology*