Covered perforated aortocoronary saphenous vein graft aneurysm.
We report a case of a 75-year-old man suffering from a covered perforated aneurysm of a saphenous bypass graft to the right coronary artery (RCA) constructed 22 years ago. Additional complete revascularization had been performed in 2001. A thoracic computed tomography scan for evaluation of fever of unknown origin had revealed a huge hematoma in front of the right heart. Coronary angiography showed open bypasses but an irregular-shaped aneurysm of the venous graft to the RCA right before the distal anastomosis. Occurrence of a new right-sided pleural effusion led to the emergent operation since rupture of the aneurysm and drainage into the pleura was likely. A massive precordial hematoma was found and the existence of the perforated aneurysm could be confirmed. After institution of cardiopulmonary bypass the graft was resected. Since the patient had a functioning bypass to the RIVP, there was no need for additional revascularization. The patient underwent an uneventful postoperative course.
Holinski
Sebastian
S
Department of Cardiovascular Surgery, Charité, Universitätsmedizin, Berlin, Germany. sebastian.holinski@charite.de
Konertz
Wolfgang
W
Beholz
Sven
S
D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010490:Pericardial Effusion / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012501:Saphenous Vein; D014057:Tomography, X-Ray Computed