scholarly journals Giant Saphenous Venous Graft Aneurysm with Compression of the Pulmonary Artery: A Rare Cause of Heart Failure

2015 ◽  
Vol 2015 ◽  
pp. 1-2
Author(s):  
Jagadeesh K. Kalavakunta ◽  
Yashwant Agrawal ◽  
Alicia Williams ◽  
Jerry W. Pratt ◽  
Frank Saltiel
Keyword(s):  
Pulmonary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Vessels ◽  
Giant Aneurysm ◽  
Computed Tomographic Angiography ◽  
Venous Graft ◽  
Circumflex Artery ◽  
Left Circumflex Artery ◽  
Computed Tomographic

We report a case of a 74-year-old man who presented with dyspnea on exertion and pedal edema. He had five-vessel coronary artery bypass graft (CABG) surgery twenty-six years ago and redo three-vessel CABG done thirteen years later. Computed tomographic angiography (CTA) of the heart and coronary vessels demonstrated a giant aneurysm arising from the saphenous venous graft (SVG) to the first obtuse marginal of the left circumflex artery compressing the pulmonary artery (PA). He underwent coronary angiography, confirming the CTA findings. Surgical and percutaneous interventions were offered, but the patient opted for conservative management due to the high risk of morbidity and mortality.

scholarly journals A case of giant saphenous vein graft aneurysm followed serially after coronary artery bypass surgery

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 155-157
Author(s):  
Tadateru Takayama ◽  
Naotaka Akutsu ◽  
Takafumi Hiro ◽  
Toshiyuki Oya ◽  
Daisuke Fukamachi ◽  
...  
Keyword(s):  
Saphenous Vein ◽  
Vein Graft ◽  
Saphenous Vein Graft ◽  
Artery Bypass ◽  
Giant Aneurysm ◽  
Computed Tomographic Angiography ◽  
Chronic Complications ◽  
Off Pump ◽  
Computed Tomographic ◽  
Tomographic Angiography

AbstractSaphenous vein graft aneurysm (SVGA) is one of the chronic complications after coronary aorta bypass grafting (CABG) and may be caused by atherosclerosis-like phenomena of the vein graft, weakness around the vein valve, rupturing of the suture of the graft anastomosis, or perioperative graft injury. We describe a case of a large, growing saphenous vein graft aneurysm that was followed serially by chest radiography and computed tomography. Eighteen years after CABG, an SVGA (23 × 24 mm) was incidentally detected. The patient was asymptomatic and was followed conservatively. Four years later, coronary computed tomographic angiography showed that the giant aneurysm had grown to 52.1 by 63.8 mm and revealed a second, smaller aneurysm. Finally, the SVG was ultimately resected without bypass via off-pump surgery. Therefore, this case suggested that aggressive treatment that includes surgical intervention should be considered before the aneurysm becomes larger, even if it is asymptomatic.

Abstract 16435: Contemporary In-Hospital Outcomes of Chronic Total Occlusion Interventions: Update From the PROGRESS-CTO (prospective Global Registry for the Study of Chronic Total Occlusion Intervention) Multicenter International Registry

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Judit Karacsonyi ◽  
Khaldoon Alaswad ◽  
Dimitrios Karmpaliotis ◽  
Oleg Krestyaninov ◽  
James Choi ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Chronic Total Occlusion ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Complication Rates ◽  
Success Rates ◽  
Circumflex Artery ◽  
Total Occlusion ◽  
Left Circumflex Artery ◽  
Procedural Success

Introduction: Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been advancing due to improvement of equipment, operator experience, and techniques. Methods: We examined contemporary outcomes of CTO PCI by analyzing the clinical, angiographic, and procedural characteristics of 7,031 CTO interventions performed in 6,984 patients at 35 participating centers between 2012 and 2020. Results: Mean age was 64.5 ± 10 years and 82% of the patients were men. The patients had high prevalence of comorbidities, such as diabetes (42%), prior coronary artery bypass graft surgery (29%), prior myocardial infarction (45%), and prior heart failure (29%). The most common CTO target vessel was the right coronary artery (53%), followed by the left anterior descending artery (26%), and left circumflex artery (20%). The mean J-CTO and PROGRESS scores were 2.41 ± 1.28 and 1.09 ± 1.01, respectively. The overall technical and procedural success rates were 85.9% and 83.8% and the rate of in-hospital major cardiac adverse events (MACE) was 2.06%. Technical success and procedural success rates were lower for higher values of J-CTO and PROGRESS scores, and MACE rate was higher ( Figure 1 ). The final successful crossing strategy was antegrade wire escalation in 53.7%, retrograde in 19.9%, and antegrade dissection reentry in 14.6%. The overall median air kerma radiation dose, contrast volume, procedure and fluoroscopy time were 2.30 (1.30, 3.90) Gray, 225 (160, 305) ml, 115 (75, 170) and 43 (26, 70) minutes, respectively. Conclusions: Using a combination of crossing strategies, high success and acceptable complication rates can be achieved in CTO PCI among various centers and patient populations.

scholarly journals Noninvasive Detection of Coronary Artery Bypass Graft Patency by Intravenous Electron Beam Computed Tomographic Angiography

2003 ◽  
Vol 44 (6) ◽  
pp. 811-822 ◽  
Author(s):  
Shoji Yamakami ◽  
Junji Toyama ◽  
Mitsuhiro Okamoto ◽  
Toyoaki Matsushita ◽  
Yoshimasa Murakami ◽  
...  
Keyword(s):  
Electron Beam ◽  
Coronary Artery ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Graft Patency ◽  
Computed Tomographic Angiography ◽  
Noninvasive Detection ◽  
Artery Bypass Graft ◽  
Computed Tomographic ◽  
Tomographic Angiography

scholarly journals Role of Computerized Tomography in Evaluation of Coronary Bypass Grafts—Special Reference to Women

2020 ◽  
Vol 5 (01) ◽  
pp. 57-64
Author(s):  
Sujata Patnaik ◽  
Sri Rama Murty ◽  
Amaresh Rao ◽  
Susarla Rammurti
Keyword(s):  
Computerized Tomography ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Coronary Vessels ◽  
Multislice Ct ◽  
Cardiac Motion ◽  
Coronary Imaging ◽  
Coronary Bypass Grafts ◽  
And Gender ◽  
Gender Specific

AbstractComputerized tomography-coronary angiography (CT-CAG) is gaining popularity as an alternative to conventional CAG to evaluate grafts in a post-coronary artery bypass graft (post-CABG) patient, since it is a noninvasive procedure and is less influenced by cardiac motion. The primary challenge is to image a rapidly beating heart. With introduction of 64-slice scanner, the coronary imaging became a possibility with acceptable accuracy. In recent years, with the development of 128,256 and 320 multislice CT scanners, further enhancement in the temporal and spatial resolution is achieved due to lesser influence of the respiratory and cardiac motion, enhancing the accuracy of the lesion assessment in the grafts and the native vessels. Achieving low heart rate and artifact-free image acquisition, proper reconstruction, and image interpretation are challenges to the radiologists and the technicians involved in coronary imaging. Women pose special subset because of smaller sized coronary vessels, interference due to breast shadows, low-referrals, and gender-specific reluctance to accept the procedure itself. Cardiologists and radiologists caring for these patients must be familiar with the pros and cons of CT-CAG and gender-specific challenges.

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