Case Session 01: Ischemic Heart Disease and Acute Chest Pain (2018)-Thrombosed Saphenous Vein Graft Aneurysm Mistaken for a Right Atrial Mass

Thrombosed Saphenous Vein Graft Aneurysm Mistaken for a Right Atrial Mass

Video Transcription

Video Summary

A 78-year-old man with prior CABG and AAA repair had persistent dyspnea and fatigue. Echocardiography showed a 2.9 x 3.2 cm right atrial mass with normal LV function. Initial CMR interpretation suggested thrombus, and anticoagulation was started. On expert review, MRI and CT showed the “mass” was actually a thrombosed distal saphenous vein graft aneurysm compressing the right atrium near the IVC. Coronary angiography confirmed a patent graft with aneurysm and lesions. He underwent PCI with three covered stents, improving symptoms. This rare late CABG complication has no clear guidelines; treatment depends on associated complications.

Keywords

saphenous vein graft aneurysm

right atrial mass

coronary artery bypass grafting

covered stent PCI

thrombosed aneurysm