Complete excision of giant calcified saphenous vein graft aneurysm in redo coronary artery bypass grafting

A 73-year-old female who first underwent coronary artery bypass graft surgery in 1987 represented in 2008 with recurrent angina. Coronary angiography demonstrated a giant calcified aneurysm of the saphenous vein graft (SVG) to the right coronary artery bracketed by severe stenoses in addition to severe disease in the native vessels. Following 64-slice computed tomography coronary angiography, total resection of the aneurysm with en-bloc excision of the contagious right atrial free wall and ascending aorta were accomplished during redo coronary revascularization. The pathophysiology of SVG aneurysm, the clinical relevance and therapeutic approaches will be discussed in light of this case. (C) 2011 Published by European Association for Cardio-Thoracic Surgery. All rights reserved.