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"Water running in my chest": Delayed spontaneous rupture of an aortocoronary saphenous vein graft aneurysm.

ABSTRACT: Saphenous vein graft aneurysm is an uncommon condition and knowledge about its natural history, and a multi-specialty heart team approach is of utmost importance for better clinical outcomes. This case highlights importance of percutaneous intervention as a viable therapeutic option in the case of saphenous vein graft aneurysms.

SUBMITTER: Gnall E

PROVIDER: S-EPMC8077387 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Aortocoronary Saphenous Vein Graft Aneurysm: Diagnosis Using Color Doppler and Contrast Transesophageal Echocardiography.

Project description: Not available

| S-EPMC8712998 | biostudies-literature

Percutaneous closure of giant saphenous vein graft aneurysm.

Project description:BackgroundAneurysmal dilatation of saphenous vein grafts used for coronary artery bypass grafting is a rare complication. These aneurysms are often large in calibre and pose a risk of rupture with significant haemorrhage.Case summaryWe describe a case whereby a large saphenous vein graft aneurysm is closed percutaneously using a vascular plug to cease flow and promote thrombosis of the aneurysm whilst reconstructing the occluded native artery to negate ischaemia.ConclusionSaphenous vein graft aneurysms following coronary artery bypass graft are rare and late complications. The preferred modality of closure is via percutaneous approach that requires meticulous planning to achieve a good outcome.

| S-EPMC10586192 | biostudies-literature

A case of giant saphenous vein graft aneurysm successfully treated with catheter intervention.

Project description:The patient was a 67-year-old man who had undergone coronary artery bypass graft surgery using a saphenous vein graft (SVG) 22 years before. Computed tomography angiogram revealed a large aneurysm of the SVG (38 × 42 mm in diameter; 80-mm long) and total occlusion of the left anterior descending artery (LAD). We first performed percutaneous coronary intervention for chronic total occlusion of the native LAD with bi-directional approach via the SVG. One month later, we performed the trans-catheter embolization of the SVG and occluded the SVG using multiple coils. This case demonstrates that trans-catheter embolization after recanalization of native coronary artery is an effective strategy to treat an SVG aneurysm. © 2015 Wiley Periodicals, Inc.

| S-EPMC4736683 | biostudies-literature

Rapidly expanding saphenous vein graft myoctic aneurysm causing ST-elevation myocardial infarction: a case report.

Project description:BackgroundMycotic aneurysms of coronary vein grafts are rare and associated with high mortality. They are most commonly a result of surgical or percutaneous intervention, and present with complications including myocardial infarction (MI), infective endocarditis. A recent literature review identified 97 cases of mycotic coronary aneurysms in total.Case summaryA 49-year-old man with a history of coronary artery bypass grafting and septic arthrithis presented with chest pain and fevers and ST elevation on electrocardiogram. Urgent angiogram showed an aneurysmal saphenous vein graft from the PL branch to PDA-no acute intervention was performed due to concern about bacteraemia. Methicillin-sensitive Staphylococcus aureus was grown in urine and blood but no focus of infection was identified. Despite treatment with antibiotics and antiplatelets, the patient returned with evidence of expansion of the SVG aneurysm requiring surgical resection.DiscussionThis case highlights the difficulty in treating acute coronary syndromes involving mycotic aneurysms. Multimodal imaging approaches are useful to identify suspected infection, but false negatives occur. Due to high risk of rupture or haemorrhage, there are limited options for urgent reperfusion in cases of MI with mycotic aneurysm, demonstrating the need for an individualized approach and close follow-up.

| S-EPMC7180533 | biostudies-literature

Huge saphenous vein graft aneurysm presenting as non-ST elevation myocardial infarction and compressing the heart.

Project description:Coronary artery bypass grafting (CABG) surgery maintains an important role in the treatment of coronary artery disease. The huge saphenous vein graft aneurysm (HSVGA) is rare and occurs as a late complication after CABG. Here, we reported a case of HSVGA presenting as non-ST elevation myocardial infarction.

| S-EPMC5067452 | biostudies-literature

Stable Hemodynamics within "No-Touch" Saphenous Vein Graft.

Project description:PURPOSE:To investigate the hemodynamics characteristics of the "no-touch" saphenous vein graft (SVG) conduits by nicardipine intraluminal administration in vivo experiment. METHODS:A total of 59 consecutive patients were enrolled and underwent a sequential SVG to three non-left anterior descending (LAD) targets with the average runoff ≤2 mm, 30 with "no-touch" harvest technique (group A) and 29 with conventional preparation (group B). The patients were subject to nicardipine intraluminal injection during off-pump coronary artery bypass grafting (CABG) procedure. The intraoperative flow was measured with the ultrasonic transit time flow meter (TTFM), and the graft patency testified by multi-detector computed tomography (MDCT) angiography, respectively. RESULTS:The baseline blood flow was higher in group A than that in group B (p <0.05). However, the increases in blood flow of SVG conduits in group A were lower than those in group B with 19.7 ± 5.9 vs. 35.4 ± 9.2 mL/min, 14.8 ± 5.6 vs. 23.1 ± 6.8 mL/min, 6.6 ± 2.1 vs. 11.2 ± 4.3 mL/min before the first, second, and third anastomose after nicardipine intraluminal administration, respectively (all p <0.01). CONCLUSIONS:No-touch SVGs were associated with higher baseline blood flow and less rises after nicardipine intraluminal administration during off-pump CABG procedure compared with conventional preparation. The no-touch SVGs seemed to be less spastic and well-tolerated on flow dilatation.

| S-EPMC7184034 | biostudies-literature

Saphenous vein graft failure: seeing the bigger picture.

Project description: Not available

| S-EPMC6560559 | biostudies-literature

Internal jugular vein reconstruction using a triple-paneled great saphenous vein graft.

Project description:BackgroundDonor-recipient diameter discrepancy can be problematic when using an autologous great saphenous vein graft for internal jugular vein reconstruction. A triple-paneled method of saphenous vein grafting is one solution.Case presentationA 54-year-old man with a thyroid papillary carcinoma underwent total thyroidectomy and bilateral neck dissection. An 8-cm segment of the right internal jugular vein was resected. For reconstruction, a 30-cm segment of the great saphenous vein was harvested and divided into three pieces of equal length. After opening each piece longitudinally, they were sutured together in a side-by-side fashion to create a cylinder that was used to reconstruct the internal jugular vein defect. The graft was patent 10 months after the surgery.ConclusionThe triple-paneled method is feasible for autologous great saphenous vein graft reconstruction of the internal jugular vein.

| S-EPMC9841726 | biostudies-literature

Use of Lithotripsy in a Calcified Saphenous Vein Graft.

Project description:Percutaneous coronary interventions in saphenous vein grafts can pose a variety of challenges, such as severely calcified lesions. If these lesions are nondilatable, lithotripsy can arguably be a proper tool for lesion preparation. We present a case in which a nondilatable, calcified saphenous vein graft was successfully treated using Shockwave lithotripsy. (Level of Difficulty: Intermediate.).

| S-EPMC8299138 | biostudies-literature

Impact of Graft Velocity on Saphenous Vein Graft Atherosclerosis after Coronary Artery Bypass Grafting.

Project description:PurposeSaphenous vein grafts (SVGs) sometimes occur as vein graft stenosis or failure in coronary artery bypass grafting. The purpose of this study was to detect the factors affecting vein graft atherosclerosis.MethodsWe performed two analysis. In the first analysis, we enrolled 120 grafts using conventionally harvested saphenous vein graft (C-SVG) and followed-up with multiple coronary computed tomography angiography (CCTA). We examined the factors that contribute to the graft atherosclerosis defined by graft failure at subsequent CCTA or substantial progression of graft stenosis (a decrease of ≥0.6 mm in diameter). In the second analysis, 66 grafts using no-touch harvested saphenous vein graft (N-SVG) were compared with those in the first analysis using C-SVG, focusing on the differences in intraoperative factors using propensity score-matched analysis.ResultsIn the first analysis, graft atherosclerosis+ group comprised 27 grafts, which had a larger SVG diameter, lower graft velocity, and higher graft/native ratio in diameter than the graft atherosclerosis- group. In the multivariable analysis, slow graft velocity and graft/native ≥2 in diameter were independently associated with the graft atherosclerosis. In the second analysis, the N-SVG group had a much greater graft velocity than the C-SVG group.ConclusionLower graft velocity and higher graft/native ratio in diameter were associated with the graft atherosclerosis. The N-SVG group had increased graft velocity, which may contribute to prevent the graft atherosclerosis.(Trial registration: UMIN Clinical Trial Registry no. UMIN000050482. Registered 3 March 2023, retrospectively registered.).

| S-EPMC10902658 | biostudies-literature

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