Inadvertent anastomosis of saphenous vein graft to a cardiac vein detected with coronary computed tomographic angiography.
A 34-year-old man with a prior history of Hodgkin's disease and coronary artery bypass surgery for radiation-induced left main disease presented with persistent chest pain. Cardiac catheterization showed near simultaneous filling of the venous system during arterial injection and could not precisely delineate the insertion point of the vein graft anastamosis to the diagonal branch, and the patient was referred for coronary computed tomography angiography (CTA). CTA demonstrated that the anastamosis of the graft was with a cardiac vein. This case illustrates the valuable complementary role of both angiographic methodologies in confirming a complex anatomic diagnosis.
Al-Mallah
Mouaz
M
Heart and Vascular Institute, Henry Ford Hospital, Detroit MI 48202, USA.
Mohyi
James
J
Ananthasubramaniam
Karthik
K
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D001165:Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000209:etiology*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D017023:Coronary Angiography / Q000379:methods*; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000009:adverse effects*; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*; D014057:Tomography, X-Ray Computed / Q000379:methods*