Aneurysms of an aorto-coronary artery saphenous vein bypass graft--a case report.

A 62 year old man with severe angina pectoris underwent aoroto-coronary saphenous vein graft implantation. After a four month asymptomatic period the patient underwent aorto-coronary graft angiography. Left anterior descending graft opacification demonstrated multiple venous aneurysmal dilations. The clinical significance of this finding is currently unknown but such saphenous vein disease warrants further investigation. Saphenous vein grafts have been utilized to replace or bypass obstructed and diseased peripheral arteries such as those of the carotid and femoral-popliteal vascular systesm. In 1967 Favaloro introduced the saphenous vein as a means for bypassing local obstructions in diseased coronary arteries of human subjects. Since the advent of the aorto-coronary saphenous vein bypass graft procedure several studies have reported pathologic alterations of these grafts at post-mortem examination or at the time of re-operation. Other investigators have also noted changes in these venous grafts when they have been implanted in peripheral vessels. We report here a patient with aneruysmal dilations of an aorto-coronary artery saphenous vein bypass graft. Furthermore, possible mechanisms which might produce such venous aneurysms and the clinical significance of such an entity are discussed.