Coronary artery venous bypass graft aneurysm with symptomatic coronary artery emboli.

A 53 year old man, asymptomatic for 9 years after aorto-right coronary artery venous bypass surgery, developed two prolonged episodes of myocardial ischemia during a 7 month interval. Diagnostic exercise tests subsequent to each episode were normal. Coronary angiography demonstrated marked dilation with filling defects of the venous bypass graft. A large thrombus-filled venous bypass graft aneurysm was excised at surgery. Spontaneous coronary artery embolization related to a venous bypass graft aneurysm has not been described previously, but may become more frequent as survival and follow-up after coronary bypass surgery lengthen.