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CARDIAC SURGERY _____________________________________________________

Aneurysm of a Saphenous Vein Aortocoronary Graft Marko T. Boskovski, M.D.,* Igor Gosev, M.D.,* Raphael Bueno, M.D.,y Michael L. Steigner, M.D.,z Sachin Saboo, M.D.,z and Sary F. Aranki, M.D.* *Division of Cardiac Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts; yDivision of Thoracic Surgery, Department of Surgery, Brigham and Women’s Hospital, Boston, Massachusetts; and zDepartment of Radiology, Brigham and Women’s Hospital, Boston, Massachusetts doi: 10.1111/jocs.12308 (J Card Surg 2015;30:270–271) A 79-year-old male who underwent coronary artery bypass graft surgery (free LIMA, two vein grafts) in 1990 was admitted with exertional dyspnea. A chest computed tomography (CT) revealed a solid lingular mass (Fig. 1), which, on CT-guided biopsy, was shown to be an adenocarcinoma. In addition, there was a large bilobed, partially thrombosed aneurysm of the obtuse

Figure 1. Chest CT revealing a lingular mass (blue arrow).

Conflict of interest: The authors acknowledge no conflict of interest in the submission. Address for correspondence: Igor Gosev, M.D., Division of Cardiac Surgery, Department of Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115. Fax: 617-264-6369; e-mail: [email protected]

marginal vein graft (Fig. 2). A 3D volume-rendered reconstruction showed a 5.8 cm  6.2 cm superior lobe and a 8.7 cm  6.6 cm inferior lobe aneurysm (Fig. 3). Following a diagnostic mediastinoscopy, he developed pulmonary edema and persistent hypoxemia, and therefore surgical correction of the aneurysm was not pursued.

J CARD SURG 2015;30:270–271

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Figure 2. Chest CT revealing the superior (yellow arrow) and inferior (red arrow) lobes of the partially thrombosed saphenous graft aneurysm. PA, pulmonary artery.

Figure 3. 3D reconstruction of the saphenous graft aneurysm (outlined with a dashed red line).

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Aneurysm of a saphenous vein aortocoronary graft.

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