A saphenous vein graft aneurysm with fistula development to the right atrium: surgical management of a rare bypass graft complication.
A patient presented late following coronary artery bypass surgery with recurrent angina. Investigations revealed a saphenous vein graft aneurysm, which subsequently formed a fistula with the right atrium. This was managed by surgical excision and repair followed by regraft of the run-off territory. Intraoperatively, the left internal mammary artery, a patent graft to the left anterior descending artery, was isolated from the circulation during aortic cross-clamping by preoperative placement of a percutaneous balloon catheter within this graft. Surgery was successful and the patient was discharged symptom-free one week later.
Hickey
Edward J
EJ
The Hospital for Sick Children, Ontario, Canada. edward.hickey@sickkids.ca
Velissaris
Theodore
T
Tsang
Geoffrey M
GM
D000368:Aged; D000783:Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000792:Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery; D005500:Follow-Up Studies; D006325:Heart Atria; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D012086:Reoperation; D018570:Risk Assessment; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000379:methods