Saphenous vein graft aneurysm with right atrium fistula

Case contributed by Maxim Stalkov
Diagnosis certain

Presentation

CABG 22 years ago. Presented with worsening dyspnea and atrial fibrillation.

Patient Data

Age: 75 years
Gender: Male

Cardiac CT shows aneurysmal dilatation of aorta-RCA saphenous vein graft with a wide fistulous connection to the right atrium.

Case Discussion

Saphenous vein graft aneurysms are a rare (0.07%) late complication of CABG. They are usually asymptomatic and identified incidentally, but can present with rupture, fistula formation and vascular compromise due to compression of adjacent vascular structures.

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