An 86-year-old man presented with exertional dyspnoea 22 years after coronary surgery. Multimodality imaging demonstrated a large aneurysm of the aorto-coronary saphenous vein graft supplying the right coronary artery (Fig. 1a–c and Videos 1 and 2). Conservative management was advised owing to multiple co-morbidities.
(a) TOE, modified bicaval view, demonstrates a ‘mass’ in close association to the right atrium (white arrow), (b) TruFISP cardiac magnetic resonance demonstrates that the aneurysm (white arrow) has a perfused central lumen and there was perfusion of the distal right coronary artery, (c) multislice CT demonstrates a grossly aneurysmal saphenous vein graft with a large amount of mural thrombus supplying the distal right coronary artery. Ao: aorta; CS: coronary sinus; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle; Th: mural thrombus; white arrow: aneurysm.
(a) TOE, modified bicaval view, demonstrates a ‘mass’ in close association to the right atrium (white arrow), (b) TruFISP cardiac magnetic resonance demonstrates that the aneurysm (white arrow) has a perfused central lumen and there was perfusion of the distal right coronary artery, (c) multislice CT demonstrates a grossly aneurysmal saphenous vein graft with a large amount of mural thrombus supplying the distal right coronary artery. Ao: aorta; CS: coronary sinus; LA: left atrium; LV: left ventricle; RA: right atrium; RV: right ventricle; Th: mural thrombus; white arrow: aneurysm.
Appendix A Supplementary data
Supplementary data associated with this article can be found, in the online version, at doi:10.1016/j.ejcts.2009.11.009.
