Eur J Cardiothorac Surg 2006;29:410
© 2006 Elsevier Science NL
Images in cardio-thoracic surgery |
Giant aneurysm of an aortocoronary saphenous bypass graft
Frank Breuckmann
a
,
*
,
Kai Nassenstein
b
,
Joerg Barkhausen
b
,
Raimund Erbel
a
a Department of Cardiology, West-German Heart Center Essen, University of Duisburg-Essen, Hufelandstrasse 55, D-45122 Essen, Germany
b Department of Diagnostic and Interventional Radiology and Neuroradiology, West-German Heart Center Essen, University of Duisburg-Essen, Essen, Germany
Received 2 November 2005;
accepted 16 December 2005.
* Corresponding author. Tel.: +49 201 723 4888; fax: +49 201 723 5401. (Email: Frank.Breuckmann{at}medizin.uni-essen.de).
Key Words: Aneurysm • Aortocoronary bypass • X-ray • Computed tomography
An aortocoronary saphenous venous bypass aneurysm presented as a mediastinal mass in an 81-year-old man with chest pain. While initially evaluated by X-ray (Fig. 1A and B), CT-angiography provided most useful diagnostic information demonstrating a saphenous graft to the right coronary artery appearing severely degenerated, aneurysmally enlarged, and partially thrombotically occluded (Fig. 1C and D).
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Fig. 1. (A and B) Conventional X-ray images of an 81-year-old man (A: posterior-anterior image; B: left lateral image) showed an unspecific 10-cm lobulated anterior mediastinal mass (arrows). (C and D) CT angiography (C: cross-sectional image; D: multiplanar reconstruction) disclosed a degenerated saphenous vein graft with an exceptional aneurysmally enlargement of up to 8 cm in diameter and embedded fragments of a dilated partly thrombotic contrasted lumen (arrows), together consistent with the diagnosis of a giant partially thrombotic aneurysm of an aortocoronary saphenous bypass graft. Also note a curvilinear calcification and myocardial wall thinning presumably from a previous myocardial infarction.
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