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J Thorac Cardiovasc Surg 2007;134:230-232
© 2007 The American Association for Thoracic Surgery

Brief Communication

Pseudoaneurysm of a saphenous bypass treated with covered endograft in the ascending aorta

Raphaël Coscas, MDa, Isabelle Javerliat, MDa, Arash M. Tofigh, MDa, Thomas Hebert, MDb, Mathieu Jablonski, MDb, Philippe Cluzel, MDb, Edouard Kieffer, MDa, Fabien Koskas, MD, PhDa,*

a Department of Vascular Surgery, Groupe Hospitalier Pitié-Salpétrière, Paris, France
b Department of Radiology, Groupe Hospitalier Pitié-Salpétrière, Paris, France.

Received for publication January 21, 2007; revisions received February 6, 2007; accepted for publication February 19, 2007.

* Address for reprints: Fabien Koskas, MD, PhD, Service de Chirurgie Vasculaire, Groupe hospitalier Pitié-Salpétrière, 47-83 Boulevard de l’Hôpital 75651 Paris Cedex 13. (Email: fabien.koskas@psl.ap-hop-paris.fr).

The first 20% of the full text of this article appears below.

Aneurysms and pseudoaneurysms complicating aorta–coronary bypasses with the saphenous vein are a rare but possibly underestimated complication. Riahi and associates1Go reported the first case in 1975. We report the first case of a saphenous bypass pseudoaneurysm treated with a homemade endograft in the ascending aorta.

Clinical Summary

A 78-year-old man was referred to our hospital with an enlarging left hilar mass found on a routine chest x-ray film. His medical history included chronic renal insufficiency with dialysis, chronic heart failure, aorta–bifemoral bypass, and double aorta–coronary bypass grafting 17 years ago. He had undergone a pedicled left internal thoracic artery graft to the left anterior descending artery and a reversed saphenous vein graft to the first obtuse marginal branch. Since that time, the patient had remained free of symptoms.

On examination, the patient was afebrile with stable hemodynamics. He did not have any cardiac or pulmonary symptoms.

A computed tomographic scan revealed a 75-mm proximal pseudoaneurysm resulting from a disruption of the aortic anastomosis (Figure 1, A). Cardiac catheterization showed a saccular . . . [Full Text of this Article]






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Copyright © 2007 by The American Association for Thoracic Surgery.