Surgical Treatment of Saphenous Vein Graft Aneurysms After Coronary Artery Revascularization
| Autor: | Soon J. Park, Joseph A. Dearani, Thoralf M. Sundt, Basar Sareyyupoglu, Ibrahim Ucar, Hartzell V. Schaff |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease Aneurysm Ruptured Anastomosis Coronary Angiography Chest pain Revascularization Asymptomatic Young Adult Pseudoaneurysm Aneurysm medicine Humans Saphenous Vein Coronary Artery Bypass Ligation Aged Retrospective Studies Aged 80 and over Vascular disease business.industry Middle Aged medicine.disease Prosthesis Failure Surgery Treatment Outcome Female Radiology medicine.symptom Cardiology and Cardiovascular Medicine business Complication Follow-Up Studies |
| Zdroj: | The Annals of Thoracic Surgery. 88:1801-1805 |
| ISSN: | 0003-4975 |
| DOI: | 10.1016/j.athoracsur.2009.07.048 |
| Popis: | Background Saphenous vein graft (SVG) aneurysms (SVGAs) after coronary artery bypass grafting (CABG) occur rarely. Most reports are anecdotal. To determine early and late outcomes of surgical treatment, we reviewed our experience with management of this rare complication of surgical revascularization. Methods From July 1975 to October 2007, 16 patients (15 men), mean age, 60.9 ± 14.6 years, underwent repair of aortocoronary SVGAs. Results Chest pain was present in 11 of 16 patients. The rest were asymptomatic. The average maximum diameter of the SVGA was 64 ± 30 mm. The concern of SVGA rupture was the primary indication for operation in 9 patients (56%). Repair in the remaining patients occurred during other cardiac operations. A pseudoaneurysm (75%) at the body or anastomotic sites of the SVG was the most common cause of SVGA. In 8 patients (50%), the aneurysm involved SVG anastomotic sites. Thirteen patients (81%) had intraluminal thrombi. Vein grafts with aneurysm were patent in 9 patients (56%). Surgical procedures included excision of the aneurysm and direct distal coronary target vessel revascularization in 10 (63%), excision and interposition vein graft in 5 (31%), and exclusion by ligation in 1 (6%). Median follow-up was 7 years (maximum, 20 years). Survival was 83% at 5 years and 72% at 10 years after SVGA repair. Conclusions Ischemic symptoms often accompany SVGA, and operation is indicated to prevent rupture. Ligation or excision of SVGA with simultaneous revascularization appears to be the optimal therapy, with satisfactory midterm and long-term results. |
| Databáze: | OpenAIRE |
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