Infected saphenous vein coronary artery bypass graft with mycotic aneurysm. Fatal dehiscence of the proximal anastomosis.

A 33-year-old man underwent coronary artery bypass graft surgery for relief of angina pectoris. His postoperative course was complicated by hemorrhage and mediastinitis. Death, which occurred after severe hemorrhage from the operative site, was shown at autopsy to be caused by dehiscence of the proximal anastomosis of the right coronary artery graft. The same graft also had a mycotic aneurysm in its midportion. Graft disruption thus appears to be a potential complication of mediastinal infection in patients with saphenous vein bypass grafts.