Saphenous Vein Graft Aneurysms Differential Diagnoses

  • Author: Jesse P Jorgensen, MD; Chief Editor: Eric H Yang, MD   more...
 
Updated: Oct 4, 2011
 
 

Differential Diagnoses

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Contributor Information and Disclosures
Author

Jesse P Jorgensen, MD  Fellow, Department of Cardiology, Emory University School of Medicine

Jesse P Jorgensen, MD is a member of the following medical societies: American College of Cardiology and American Heart Association

Disclosure: Nothing to disclose.

Coauthor(s)

Tarek Helmy, MD, FACC  Assistant Professor of Clinical Medicine, Division of Cardiovascular Diseases, University of Cincinnati School of Medicine

Tarek Helmy, MD, FACC is a member of the following medical societies: American College of Cardiology, American College of Physicians-American Society of Internal Medicine, and American Heart Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Craig T Basson, MD, PhD  Gladys and Roland Harriman Professor of Medicine, Director of the Center for Molecular Cardiology, Director of Cardiovascular Research, Division of Cardiology, Department of Medicine, Weill Cornell Medical College; Attending Physician, New York Presbyterian Hospital

Craig T Basson, MD, PhD is a member of the following medical societies: American College of Cardiology and American Heart Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Steven J Compton, MD, FACC, FACP  Director of Cardiac Electrophysiology, Alaska Heart Institute, Providence and Alaska Regional Hospitals

Steven J Compton, MD, FACC, FACP is a member of the following medical societies: Alaska State Medical Association, American College of Cardiology, American College of Physicians, American Heart Association, American Medical Association, and Heart Rhythm Society

Disclosure: Nothing to disclose.

Amer Suleman, MD  Private Practice

Amer Suleman, MD is a member of the following medical societies: American College of Physicians, American Heart Association, American Institute of Stress, American Society of Hypertension, Federation of American Societies for Experimental Biology, Royal Society of Medicine, and Society of Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Chief Editor

Eric H Yang, MD  Associate Professor of Medicine, Director of Interventional Cardiology Fellowship Program, Henry Ford Hospital

Eric H Yang, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Christian Birkedal, MD and J Thomas Williams, MD to the development and writing of this article.

References

  1. Riahi M, Vasu CM, Tomatis LA, et al. Aneurysm of saphenous vein bypass graft to coronary artery. J Thorac Cardiovasc Surg. Aug 1975;70(2):358-9. [Medline].

  2. Sherry CS, Harms SE. MR imaging of pseudoaneurysms in aortocoronary bypass graft. J Comput Assist Tomogr. May-Jun 1989;13(3):426-9. [Medline].

  3. Khabeishvili G, Shaburishvili T, Wann S, et al. Saphenous vein graft pseudoaneurysm: diagnosis by transesophageal echocardiography and magnetic resonance imaging. J Am Soc Echocardiogr. May-Jun 1995;8(3):338-40. [Medline].

  4. Benari B, Erel J, Allen HN, et al. Aneurysm of saphenous vein bypass graft detected by first-pass radionuclide ventriculography. Am Heart J. Jan 1997;133(1):133-6. [Medline].

  5. Ennis BM, Zientek DM, Ruggie NT, et al. Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three-dimensional reconstruction. Cathet Cardiovasc Diagn. Apr 1993;28(4):328-31. [Medline].

  6. Dieter RS, Patel AK, Yandow D, Pacanowski JP Jr, Bhattacharya A, Gimelli G, et al. Conservative vs. invasive treatment of aortocoronary saphenous vein graft aneurysms: Treatment algorithm based upon a large series. Cardiovasc Surg. Dec 2003;11(6):507-13. [Medline].

  7. Bosmans JM, Claeys MJ, Dilling D, Vrints CJ. Unsuccessful long-term outcome after treatment of a vein graft false aneurysm with a polytetrafluoethylene-coated Jostent. Catheter Cardiovasc Interv. May 2000;50(1):105-8. [Medline].

  8. [Best Evidence] Brilakis ES, Lichtenwalter C, de Lemos JA, Roesle M, Obel O, Haagen D, et al. A randomized controlled trial of a paclitaxel-eluting stent versus a similar bare-metal stent in saphenous vein graft lesions the SOS (Stenting of Saphenous Vein Grafts) trial. J Am Coll Cardiol. Mar 17 2009;53(11):919-28. [Medline].

  9. Mylonas I, Sakata Y, Salinger MH, Feldman T. Successful closure of a giant true saphenous vein graft aneurysm using the Amplatzer vascular plug. Catheter Cardiovasc Interv. Apr 2006;67(4):611-6. [Medline].

  10. Mehilli J, Pache J, Abdel-Wahab M, et al. Drug-eluting versus bare-metal stents in saphenous vein graft lesions (ISAR-CABG): a randomised controlled superiority trial. Lancet. Sep 17 2011;378(9796):1071-8. [Medline].

  11. Agarwal SC, Adams PC, Ahmed JM. Aneurysm of saphenous vein graft causing anterior myocardial infarction by possibly compressing left internal mammary artery. Int J Cardiol. May 10 2006;109(2):284-5. [Medline].

  12. Anfinsen OG, Aaberge L, Geiran O, Smith HJ, Aakhus S. Coronary artery aneurysms mimicking cardiac tumor. Eur J Echocardiogr. Aug 2004;5(4):308-12. [Medline].

  13. Carasso S, Sternik L, Kuperstein R, Feinberg MS. A large saphenous vein graft aneurysm presenting as a right atrial mass: a case report. Echocardiography. Jul 2006;23(6):499-502. [Medline].

  14. Chiappini B, Poncelet A, Noirhomme P, Verhelst R, Rubay J, Funken JC. Giant aneurysm of aortocoronary saphenous vein graft compressing the left pulmonary artery. J Card Surg. Jul-Aug 2006;21(4):425-7. [Medline].

  15. Couto WJ, Livesay JJ, Allam A. Off-pump repair of a giant pseudoaneurysm of a distal saphenous vein bypass graft. Ann Thorac Surg. Dec 2005;80(6):2376-8. [Medline].

  16. Fares W, Sharifi M, Steele R, Sarhill N, Sopko J, Ramana CV, et al. Superior vena cava syndrome secondary to saphenous venous graft aneurysm with right atrial fistula. Catheter Cardiovasc Interv. Sep 2003;60(1):45-7. [Medline].

  17. Gyenes G, Lazzam C, Feindel C, Roth SL. Successful treatment of a saphenous vein graft pseudoaneurysm with PTFE-covered JoStents. Can J Cardiol. Apr 2003;19(5):569-71. [Medline].

  18. Hameed A, Hanna-Moussa S, David S. Use of multiple stents to seal off an epicardial pseudoaneurysm. J Invasive Cardiol. Jul 2003;15(7):405-7. [Medline].

  19. Hirsch GA, Johnston PV, Conte JV Jr, Achuff SC. Mycotic aortocoronary saphenous vein graft aneurysm presenting with unstable angina pectoris. Ann Thorac Surg. Oct 2004;78(4):1456-8. [Medline].

  20. Ho PC, Leung CY. Treatment of post-stenotic saphenous vein graft aneurysm: special considerations with the polytetrafluoroethylene-covered stent. J Invasive Cardiol. Oct 2004;16(10):604-5. [Medline].

  21. Ivert T, Orre L. Right thoracotomy for saphenous vein graft aneurysm causing hemoptysis. Ann Thorac Surg. May 2006;81(5):1885-7. [Medline].

  22. Ivert T, Orre L. Right thoracotomy for saphenous vein graft aneurysm causing hemoptysis. Ann Thorac Surg. May 2006;81(5):1885-7. [Medline].

  23. Jamshidi P, Resink T, Erne P. Staged stenting of a long aneurysm of a saphenous vein coronary artery bypass graft. J Invasive Cardiol. Jan 2008;20(1):E1-5. [Medline].

  24. Kang G, Shepherd J, Ferraro R, Butler M, Petrella R. Cardiac tamponade caused by a leaking coronary saphenous vein graft aneurysm. Am J Emerg Med. Sep 2007;25(7):858.e1-2. [Medline].

  25. Kavanagh EC, Hargaden G, Flanagan F, Murray JG. CT of a ruptured vein graft pseudoaneurysm: an unusual cause of superior vena cava obstruction. AJR Am J Roentgenol. Nov 2004;183(5):1239-40. [Medline].

  26. Kim D, Guthaner DF, Wexler L. Transcatheter embolization of a leaking pseudoaneurysm of saphenous vein aortocoronary bypass graft. Cathet Cardiovasc Diagn. 1983;9(6):591-4. [Medline].

  27. Kobulnik J, Hutchison SJ, Leong-Poi H. Saphenous vein graft aneurysm masquerading as a left atrial mass: diagnosis by contrast transesophageal echocardiography. J Am Soc Echocardiogr. Dec 2007;20(12):1414.e1-4. [Medline].

  28. Maroo A, Rasmussen PA, Masaryk TJ, Ellis SG, Lincoff AM, Kapadia S. Stent-assisted detachable coil embolization of pseudoaneurysms in the coronary circulation. Catheter Cardiovasc Interv. Sep 2006;68(3):409-15. [Medline].

  29. Memon AQ, Huang RI, Marcus F, Xavier L, Alpert J. Saphenous vein graft aneurysm: case report and review. Cardiol Rev. Jan-Feb 2003;11(1):26-34. [Medline].

  30. Nishimura Y, Okamura Y, Hiramatsu T, Mori H, Hayashi H, Komori S. Hemoptysis caused by saphenous vein graft aneurysm late after coronary artery bypass grafting. J Thorac Cardiovasc Surg. Jun 2005;129(6):1432-3. [Medline].

  31. Parry DJ, Winburn IC, Wilkins GT, Bunton RW. Expanding retrograde saphenous vein graft aneurysm treated with endovascular coiling. Ann Thorac Surg. Dec 2005;80(6):2374-6. [Medline].

  32. Punnam SR, Pokala VR, Guniganti PR. Saphenous vein graft aneurysm presenting as cardiac mass on echocardiography. Am J Geriatr Cardiol. May-Jun 2005;14(3):159-61. [Medline].

  33. Quin JA, Cetindag IB, Mukerji V, Embrey RP, Grasch AL, Hazelrigg SR. Giant saphenous vein graft aneurysm. Angiology. Sep-Oct 2004;55(5):587-8. [Medline].

  34. Rogers JH, Chang D, Lasala JM. Percutaneous repair of coronary artery bypass graft-related pseudoaneurysms using covered JOSTENTs. J Invasive Cardiol. Sep 2003;15(9):533-5. [Medline].

  35. Singh SK, Sharma AK. Right hemothorax from leaking aortocoronary vein graft giant aneurysm. Asian Cardiovasc Thorac Ann. Aug 2006;14(4):336-7. [Medline].

  36. Sugimoto T, Yamamoto K, Yoshii S, Shimada K, Katsu M, Iida Y, et al. Large saphenous vein graft aneurysm with a fistula to the right atrium. Ann Thorac Cardiovasc Surg. Dec 2006;12(6):435-7. [Medline].

  37. Topaz O, Rutherford MS, Mackey-Bojack S, Prinz AW, Katta S, Salter D, et al. Giant aneurysms of coronary arteries and saphenous vein grafts: angiographic findings and histopathological correlates. Cardiovasc Pathol. Nov-Dec 2005;14(6):298-302. [Medline].

  38. Williams ML, Rampersaud E, Wolfe WG. A man with saphenous vein graft aneurysms after bypass surgery. Ann Thorac Surg. May 2004;77(5):1815-7. [Medline].

  39. Yatskar L, Rosenzweig BP, Attubato M, Axel L, Tunick PA, Kronzon I. Saphenous vein graft aneurysm masquerading as a right atrial mass. Echocardiography. Mar 2005;22(3):263-5. [Medline].

 
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CT scan demonstrating a saphenous vein graft aneurysm.
Cardiac catheterization demonstrating a saphenous vein graft aneurysm.
Aortogram demonstrating a saphenous vein graft aneurysm.
This CT scan reveals a saphenous vein graft aneurysm.
Angiogram of a saphenous vein graft to the distal right coronary artery demonstrating a large aneurysm in the mid portion of the graft. Video courtesy of John S. Douglas, MD.
Final angiogram demonstrating coils within the aneurysm, and almost complete cessation of flow from the parent vessel into the aneurysm. Video courtesy of John S. Douglas, MD.
Another view demonstrating the saphenous vein graft aneurysm. Video courtesy of John S. Douglas, MD.
The first of many coils being deployed in the aneurysm. Video courtesy of John S. Douglas, MD.
 
 
 
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