Spontaneous rupture of an aortocoronary saphenous vein graft

Spontaneous rupture of an aortocoronary saphenous vein graft Saphenous vein grafts may develop aneurysmal changes which may enlarge and require surgery or exclusion with a stent. Spontaneous rupture of a saphenous vein graft (SVG) in the absence of a pseudoaneurysm is rare. We present images of a spontaneous rupture of a SVG in the absence of a pseudoaneurysm.An 82‐year‐old male had undergone a total arch replacement and a SVG to the right coronary artery (RCA) 2 years ago. He was now admitted with chest pain and altered mental status. A computed tomogram showed extravasation from the proximal portion of the SVG (Figure ). A redo sternotomy was performed and cardiopulmonary bypass was instituted with cannulation of the right common femoral artery and vein. Active bleeding was noted from the proximal portion of the SVG which was totally disrupted. The site of the disruption was 2‐mm distal to the proximal anastomosis which was placed on the ascending aortic Dacron graft (Figure ). There was no evidence of a SVG pseudoaneurysm. A side biting clamp was placed on the proximal anastomosis and the defect was closed with a pericardial patch (Figure ). The distal graft was oversewn with a 5‐0 prolene suture. Since the distal RCA was well collateralized http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Cardiac Surgery Wiley

Spontaneous rupture of an aortocoronary saphenous vein graft

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0886-0440
eISSN
1540-8191
D.O.I.
10.1111/jocs.13531
Publisher site
See Article on Publisher Site

Abstract

Saphenous vein grafts may develop aneurysmal changes which may enlarge and require surgery or exclusion with a stent. Spontaneous rupture of a saphenous vein graft (SVG) in the absence of a pseudoaneurysm is rare. We present images of a spontaneous rupture of a SVG in the absence of a pseudoaneurysm.An 82‐year‐old male had undergone a total arch replacement and a SVG to the right coronary artery (RCA) 2 years ago. He was now admitted with chest pain and altered mental status. A computed tomogram showed extravasation from the proximal portion of the SVG (Figure ). A redo sternotomy was performed and cardiopulmonary bypass was instituted with cannulation of the right common femoral artery and vein. Active bleeding was noted from the proximal portion of the SVG which was totally disrupted. The site of the disruption was 2‐mm distal to the proximal anastomosis which was placed on the ascending aortic Dacron graft (Figure ). There was no evidence of a SVG pseudoaneurysm. A side biting clamp was placed on the proximal anastomosis and the defect was closed with a pericardial patch (Figure ). The distal graft was oversewn with a 5‐0 prolene suture. Since the distal RCA was well collateralized

Journal

Journal of Cardiac SurgeryWiley

Published: Jan 1, 2018

References

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