1. Giant venous aneurysm jeopardising internal mammary arterial graft patency
- Author
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Emmanuel Coche, Olivier Van Caenegem, Jean-Benoît le Polain de Waroux, and Laurent de Kerchove
- Subjects
Male ,Pulmonary and Respiratory Medicine ,Cardiac function curve ,medicine.medical_specialty ,Myocardial Ischemia ,Coronary Artery Disease ,Case Reports ,Internal thoracic artery ,Coronary Angiography ,Coronary artery disease ,Electrocardiography ,Aneurysm ,medicine.artery ,Internal medicine ,medicine ,Humans ,Saphenous Vein ,cardiovascular diseases ,Internal Mammary-Coronary Artery Anastomosis ,Aged ,Heart Failure ,biology ,medicine.diagnostic_test ,business.industry ,Coronary Aneurysm ,medicine.disease ,Troponin ,Prosthesis Failure ,Surgery ,Bypass surgery ,Heart failure ,cardiovascular system ,Cardiology ,biology.protein ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
The authors report a 79-year old man with a history of coronary bypass surgery, presenting with acute heart failure and elevated troponin. Coronarography revealed a giant saphenous vein graft aneurysm, which was compressing the left internal mammary artery bypass graft. This was confirmed by a multislice enhanced-ECG gated cardiac CT, showing the venous aneurysm responsible for external compression of the arterial graft and its functional occlusion. Myocardial ischaemia, the mechanism leading to cardiac failure, was confirmed by hypoperfusion of the sub-endocardial area shown by the CT. The aneurysm was surgically removed without complications. The patient recovered and his cardiac function improved. This is the first recorded case of compression of the left internal mammary artery by an giant saphenous vein graft aneurysm having triggered severe myocardial ischaemia and heart failure. The authors review the incidence and complications of giant venous bypass graft aneurysms reported in the literature.
- Published
- 2012
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