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Eur J Cardiothorac Surg 2003;24:1034
© 2003 Elsevier Science NL

Images in cardio-thoracic surgery

Giant retroaortic coronary artery bypass graft aneurysm

Karsten Knobloch*, Rainer G. Leyh, Arjang Ruhparwar, Axel Haverich

Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany

Received 19 June 2003; received in revised form 27 July 2003; accepted 21 August 2003.

* Corresponding author. Tel.: +49-511-532-2251; fax: +49-511-532-5404
e-mail: knobloch{at}thg.mh-hannover.de

Key Words: Coronary artery bypass surgery • Aneurysm • Cardiac surgery

Coronary artery bypass aneurysms are extremely rare clinical findings, appearing late and masquerading as an intra-, or paracardiac mass.

We report a 79-year-old patient who presented with dyspnoe 12 years after previous CABG with a retroaortic mass identified in computer tomography. Besides an aorta ascendens aneurysm (5 cm), a 4-cm aneurysm of a retroaortic venous saphenous graft was identified, which led to the first posterolateral branch. Surgical exclusion, CABG and aorta ascendens replacement were performed. The patient recovered early and remained asymptomatic over 13 months of follow-up (Figs. 1 and 2) .



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  		Fig. 1. Thoracic computer tomography demonstrating an aorta ascendens aneurysm (1) (5-cm diameter) as well as a retroaortic tumor (2) (4-cm diameter).

 


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  		Fig. 2. Intraoperative situs demonstrating a saphenous venous bypass aneurysm (1) 12 years after CABG to the first posterolateral branch, which appears to be retroaortic (2) venous cannula; (3) right atrium.

 



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eComment: Saphenous graft aneurysms
Interactive CardioVascular and Thoracic Surgery, June 1, 2009; 8(6): 693 - 693.
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