Document Detail


Thrombosis of a large saphenous vein graft aneurysm leading to acute myocardial infarction 21 years after coronary artery bypass grafting: role of cardiac multi-slice computed tomography.
MedLine Citation:
PMID:  21051385     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
We report a case of a 74-year-old male, who presented with an acute ST elevation posterior wall myocardial infarction (MI) 21 years following revascularization with three saphenous vein grafts (SVGs) to the left and right coronary arteries. In coronary angiography (CAG), the dilated SVG to the first marginal branch of the circumflex artery appeared only contrast enhanced in the proximal portion. The day after coronary angiography 128-slice cardiac computed tomography (CT) was performed. Cardiac CT showed a 5×3-cm incomplete thrombosed aneurysm of the proximal bypass with complete thrombotic occlusion of distal bypass grafting. With this diagnosis the patient was referred to a cardiothoracic unit for a second opinion. A surgical intervention was refused due to an increased intraoperative morbidity and occlusion of peripheral bypass portion. A follow-up CAG 10 days after infarction showed complete occlusion of the aneurysm. This case illustrates the utility of multi-slice CT to diagnose SVG aneurysm and influence clinical decisions for further treatment. This is the first report of a spontaneous SVG aneurysm thrombosis under a conservative treatment approach with recovery of the patient after MI. Clinical follow-up five months after infarction was unremarkable.
Authors:
Ludger Wilhelm Poll; Birgitta Sadra; Sarah Rühlow; Rainer Wessely
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Publication Detail:
Type:  Journal Article     Date:  2010-11-04
Journal Detail:
Title:  Interactive cardiovascular and thoracic surgery     Volume:  12     ISSN:  1569-9285     ISO Abbreviation:  Interact Cardiovasc Thorac Surg     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101158399     Medline TA:  Interact Cardiovasc Thorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  284-6     Citation Subset:  IM    
Affiliation:
Department of Radiology, Berufsgenossenschaftliche Unfallklinik Duisburg GmbH, Grossenbaumer Allee 250, D-47249 Duisburg, Germany.
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