IMAGES IN CARDIOLOGY
Giant True Saphenous Vein Graft Aneurysm
Juan Garcia-Lara, MD,
Eduardo Pinar-Bermudez, MD, PhD,
Jose Antonio Hurtado, MD and
Mariano Valdez-Chavarri, MD, PhD
Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
Manuscript received February 10, 2009;
accepted February 18, 2009.
A 60-year-old man who had undergone saphenous vein grafting to the left anterior descending artery 23 years ago complained of continuous resting chest pain for the last 48 h. No electrocardiographic changes were observed, and laboratory tests showed normal troponin T and creatine kinase levels on admittance and at 8, 12, and 24 h later. Coronary angiography was performed and showed chronic total occlusion of the left anterior descending artery and a severely degenerated and occluded saphenous vein graft. Contrast-enhanced computed tomography showed an extracardiac mass of 85 x 51 mm compressing the left atrium, corresponding to a giant aneurysmatic saphenous vein graft. The patient had severe obesity (160 cm, 100 kg, body mass index 39 kg/m2) and was not considered a good surgical candidate. One week later, the patient was scheduled for percutaneous closure of a severely degenerated saphenous vein graft. Through a right femoral artery access, 1 embolization coil was deployed, allowing complete exclusion of the aneurysmatic graft. The patient did well and was discharged 24 h later.
|
