Saphenous vein graft aneurysm-an unusual cause of mediastinal mass.

We report the case of a 78-year-old man who was incidentally found to have a large, ovoid mass on a chest X-ray. Nineteen years before, he had undergone a coronary artery bypass graft (CABG). A chest computed tomography (CT) scan revealed a 6.8 x 6.7 cm aneurysm of the saphenous vein bypass graft anastomosed to the distal right coronary artery with contrast filling only the proximal end of the graft. The inferior wall of the left ventricle was akinetic on echocardiography, suggesting prior myocardial infarction of this vascular bed. Because of the patient's comorbidities, occlusion of the graft, and prior inferior infarction, clinical observation was elected.