Surgical Strategy and Tactics for a Saphenous Vein Graft Aneurysm

Tomoaki Masuda	Shu Yamamoto	Takanori Suezawa
Takeshi Shichijo

（Department of Cardiovascular Surgery, Kagawa Prefectural Central Hospital, Takamatsu, Japan）

A 74-year-old woman underwent a triple CABG with saphenous vein grafts to the left anterior descending artery, left circumflex artery and right coronary artery（RCA）17 years previously. Periodic echocardiography by primary care doctor showed a mediastinal mass. She was referred to our hospital and we diagnosed saphenous vein graft aneurysm（SVGA）by enhanced computed tomography. The aneurysm was 60 mm in diameter and originated from the SVG, extending to the RCA. Only around the proximal anastomosis was enhanced, while the other part of the aneurysm was filled with thrombus. Coronary angiography showed collateral circulation to RCA and the other 2 grafts were patent. Resternotomy was done under cardiopulmonary bypass and closure of the proximal anastomosis with aneurysm excision was successfully performed. The postoperative course was uneventful and she was discharged on the 26th post-operative day. We report our surgical strategy in this case.

Jpn. J. Cardiovasc. Surg. 44:326-329（2015）

Keywords：coronary artery bypass grafting;saphenous vein graft;graft aneurysm