PMC5404499_01
Non-contrast computed tomography: (A) axial computed tomography of 79 x 71mm saphenous vein graft aneurysm compressing the lingular bronchus; (B) sagittal computed tomographic reconstruction of saphenous vein graft aneurysm. Hollow red arrow marks saphenous vein graft aneurysm; solid red arrow indicates compression of the lingular bronchus. Echocardiogram: (C) apical 4-chamber view demonstrating presence of a saphenous vein graft aneurysm along the atrioventricular groove.
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F1
Follow up CT angiography revealed an interval increase in size to 79 x 71mm with additional extrinsic compression of the lingular bronchus (Figure 1A and 1B). SVG aneurysm was visible by transthoracic echocardiography (Figure 1C). Stress echocardiogram demonstrated an ejection fraction of 36% and an inducible wall motion abnormality of the anterior wall.
Two-view Chest X-ray: (A) postero-anterior view demonstrating a large well circumscribed mass along the left heart border; (B) lateral view. Hollow red arrow marks saphenous vein graft aneurysm. Intraoperative photographs of SVG aneurysm repair: (C) exposure of the aneurysm's inflow with balloon occlusion catheter in situ, (D) proximal patch occlusion of the SVG.. Abbreviation: SVG, saphenous vein graft.
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F2
Pre-operative CXR demonstrated a large opacity along the left heart border (Figure 2A and 2B). The inflow to the aneurysm was occluded with an 8-Fr balloon occlusion catheter (Figure 2C). Bovine pericardial patches were fashioned to cover both the proximal and distal limbs of the vein graft (Figure 2D).