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Giant Saphenous Vein Graft Aneurysm Following Coronary Artery Bypass
Sirivan S. Seng1, Alessandra Carrillo2, Alexander Papa3, Muhammad Raza1, Charles M. Geller1
1Crozer-Chester Medical Center, Upland, PA, USA, 2Franciscan Health, Olympia Fields, IL, USA, 3Drexel University College of Medicine, Philadelphia, PA, USA.

Objective: Given the lengthy survival of patients undergoing CABG, the incidence of SVG aneurysm is steadily increasing. Although typically asymptomatic, patients may present with chest pain, shortness of breath, hemoptysis, myocardial infarctions, or shock. Coronary artery angiography provides a definitive diagnosis. Treatment largely depends on the nature of patient presentation. Symptomatic patients are typically recommended to undergo intervention, preferentially via percutaneous techniques if possible.
Methods: Single patient case review.
Results: We present a case of a 67 year old male with history of CABG x 5 with a known saphenous vein graft aneurysm who developed increasing chest pain. He was found to have significant enlargement of the aneurysm and underwent percutaneous closure of the aneurysmal neck with a 12 mm AVP II (Figure 1). Follow up one-month post-intervention revealed decreased aneurysmal size and no recurrence of symptoms.
Conclusion: In a patient with chest pain and history of CABG, SVG aneurysm should be considered in the differential.Prompt recognition by clinicians will allow for accurate and timely intervention.


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