Author + information
- Received November 5, 2013
- Accepted November 12, 2013
- Published online May 13, 2014.
- Gagandeep Singh Wander, DM∗,†,
- Rajneesh Kapoor, DM†,
- Manish Bansal, MD, DNB∗,
- Kulbir Ahlawat, MD‡ and
- Naresh Trehan, MD§
A 65-year-old man presented with chest heaviness and exertional dyspnea 2 months after coronary artery bypass grafting (CABG). Coronary angiography revealed patent saphenous vein graft to obtuse marginal, but at its distal end a jet was seen draining posteriorly into a large aneurysmal sac (A, Online Video 1). Cardiac computed tomography scan and angiography revealed the aneurysmal sac to be intramyocardial and in communication with the distal anastomosis (B). The findings were confirmed on magnetic resonance imaging (C and D [arrows indicate intramyocardial pseudoaneurysm], Online Videos 2 and 3). A covered stent was deployed percutaneously to seal off the aneurysm successfully (E and F, Online Video 4).
An inadvertent injury posteriorly in the coronary artery leading to intramural hematoma is a rare complication of CABG, which usually seals off spontaneously. However, to the best of our knowledge, formation of a progressively enlarging pseudoaneurysm and its successful closure percutaneously has never been reported previously.
- Received November 5, 2013.
- Accepted November 12, 2013.
- American College of Cardiology Foundation