Aneurysms of saphenous vein grafts as late complication of coronary artery bypass surgery: successful exclusion by percutaneous transcatheter embolization

Lacombe, Pascal; Rocha, P; Qanadli, Salah D.; Guichoux, F; Pillière, Rémy; Hajjam, Mostafa El; Foudali, Abdellatif; Bourdarias, Jean-Pierre; Dubourg, Olivier

doi:10.1007/s003300101066

Cited by 10 publications

(3 citation statements)

References 19 publications

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“…Our literature review identified 107 patients [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95]. The demographic, clinical and pathological features are summarized in ...…”

Section: Resultsmentioning

confidence: 99%

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

et al. 2005

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Aneurysmal dilatation of saphenous vein graft (SVG), first reported in 1975, is secondary to true aneurysm or pseudoaneurysm. We report 1 case and review 107 cases published since 1975. Severe SVG dilatations are large (6 ± 3 cm), occur remote from surgery (12 ± 4 years) and are life threatening, with 15.7% in-hospital mortality. Symptoms are nonspecific and the abnormality is initially observed by chest X-ray in 57% of cases. The chest X-ray abnormalities have a distinctive appearance that may suggest both diagnosis and which SVG is involved. Diagnosis is made clinically by imaging, i.e. computed tomography, echocardiography, magnetic resonance and/or surgical observation (66 cases), or most accurately by tissue evaluation by the pathologist (42 cases). Aneurysm is more common than pseudoaneurysm by a 6:1 ratio.

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Section: Resultsmentioning

confidence: 99%

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

et al. 2005

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“…Previous reports have described the use of the Graftmaster covered stent, which is composed of two layers of stent with a PTFE graft between the stents. This device is bulky and potentially problematic to deliver . New versions of covered stent, such as the Papyrus (Biotronik, Berlin, Germany), which utilizes a single layer of polyurethane, and BeStent (Bentley Innomed, Hechingen, Germany), with a single layer of stent struts, are considerably more deliverable, may be delivered through a 5 Fr sheath and ideally suited to vein graft aneurysm intervention up to a size of 5.5 mm when using standard PCI equipment over a 0.018″ guidewire (Table ).…”

Section: Discussionmentioning

confidence: 99%

Percutaneous treatment of saphenous vein graft aneurysm: Contemporary procedural considerations

Khan

Brienesse

Boyle

et al. 2019

Cathet Cardio Intervent

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While coronary artery bypass grafting remains an essential component of revascularization therapy, the use of venous conduits in the form of saphenous vein grafts is associated with a number of late sequelae, including graft stenosis and occlusion. The recognition of saphenous vein graft aneurysm, typically a late complication, may be associated with adverse outcomes. We describe the percutaneous therapy of saphenous vein graft aneurysm, utilizing contemporary devices, including newer generation covered stents, and the use of devices more commonly used in peripheral vascular intervention, reflecting the dilated nature of vein grafts. Saphenous vein graft aneurysm can be successfully treated with percutaneous therapy, avoiding the risk of repeat sternotomy and associated morbidity. The use of new generation covered stents has not been previously well reported; however, it may have an important role in the treatment of coronary artery and saphenous vein graft aneurysm. Awareness of the role of covered stents used in both coronary and peripheral intervention and the advantages of new generation devices are essential to allow optimal therapy of this uncommon, late complication. The role and potential benefits of new generation covered stents are discussed with a review of the existing literature.

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“…Embolization or stenting of the aneurysms is another treatment option [10,11]. Unfortunately, our patient deteriorated rapidly to provide the surgical treatment he needed.…”

Section: Discussionmentioning

confidence: 99%

Circulatory Failure and Lactic Acidosis Associated with Giant Saphenous Vein Graft Aneurysm

Mooi¹,

Arnoldussen²,

Noble³

2016

Insights Chest Dis

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Context: Saphenous vein graft aneurysms may be a life-threatening condition. It may take 15-20 years to fully develop and is regarded as a relatively rare and late complication of coronary artery bypass grafting. Giant aneurysms may particularly cause mechanical complications due to neighboring structure compression. Simultaneous right atrial and ventricle compressions due to saphenous vein graft aneurysms as a cause of circulatory failure and lactic acidosis are rarely demonstrated in intensive care unit patients. Case report:We hereby report a case of a 74-year-old patient who was diagnosed with circulatory failure that developed into acute cardiac failure with obstructive shock. The patient had undergone coronary bypass grafting 20 years previously. Computed tomography angiography revealed a right-sided 6.7 × 7.1 cm paracardial aneurysm, originating from the venous graft, compressing the right atrium and ventricle inflow tract. Conclusions:We hypothesize that hemodynamic instability due to right ventricular inflow obstruction contributed to circulatory failure with consequently inadequate oxygen delivery and lactic acidosis. Despite immediate supportive treatment, the clinical condition deteriorated and a percutaneous intervention with a stent or surgical ligation with excision was not feasible thereafter. Saphenous vein graft aneurysms should be considered in patients with circulatory failure who have a history of coronary artery bypass grafting.

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Aneurysms of saphenous vein grafts as late complication of coronary artery bypass surgery: successful exclusion by percutaneous transcatheter embolization

Cited by 10 publications

References 19 publications

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

Severe Dilatation of Saphenous Vein Grafts: A Late Complication of Coronary Surgery in Which the Diagnosis Is Suggested by Chest X-Ray

Percutaneous treatment of saphenous vein graft aneurysm: Contemporary procedural considerations

Circulatory Failure and Lactic Acidosis Associated with Giant Saphenous Vein Graft Aneurysm

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