Retrograde wiring: a novel technique for identifying the origin of unusual saphenous vein grafts.
BACKGROUND
In the absence of radiopaque graft markers, engaging unusual saphenous vein grafts can be challenging.


METHODS
We describe a case in which a saphenous vein graft to the first obtuse marginal branch could not be located, in spite of performing aortic root angiography. The saphenous vein graft was wired retrogradely through the native left main and the wire was advanced into the aorta, serving as a marker of the abnormally low origin of the graft that was successfully engaged with a multipurpose catheter.


RESULTS
The guidewire was successfully advanced retrogradely through the SVG into the aorta, allowing localization of the SVG ostium that was sewn in an unusually low location.


CONCLUSIONS
Retrograde SVG wiring is an advanced, "last resort" technique for identifying the ostium and cannulating unusual aortocoronary bypass grafts.
Veterans Affairs North Texas Healthcare System, Dallas, TX, USA.
Aristotelis C
AC
Papayannis
Subhash
S
Banerjee
Emmanouil S
ES
Brilakis
D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation / Q000379:methods*; D062906:Cardiac Catheters; D017023:Coronary Angiography / Q000295:instrumentation / Q000379:methods*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D005260:Female; D006083:Graft Occlusion, Vascular / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D006801:Humans; D011237:Predictive Value of Tests; D012501:Saphenous Vein / Q000000981:diagnostic imaging / Q000637:transplantation*