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S. Large saphenous vein graft aneurysm with a fistula to the right atrium. Superior vena cava syndrome secondary to saphenous venous graft aneurysm with right atrial fistula. Giant true saphenous vein graft aneurysm causing cardiac compression: a rare cause of atrial flutter. A large coronary artery saphenous vein bypass graft aneurysm with a fistula: case report and review of the literature.tion of a saphenous vein graft aneurysm by intravascular ultrasound and computerized three-dimentional reconstruction. Transcatheter embolization of a leaking pseudoaneurysm of a saphenous vein aortocoronary bypass graft. Catbet Cardiovasc Diagn 1983;9:591–594. w9x Dimitri WR, Reid AW, Dunn FG. Leaking false aneurysm of right coronary saphenous vein graft: successful treatment by percutaneous coil embol-ization. I read with great interest the recent report by Dr. Abbasi and coworkers regarding a large saphenous graft aneurysm as early as one year after coronary artery bypass grafting (CABG) surgery w1x. Interestingly, the afore-mentioned case of a saphenous graft aneurysm occurred rather early. Six years ago we encountered a 79-year-old patient who presented with dyspnea 12 years after previous CABG with a retroaortic mass identified by computer tomography w2x. Besides an aorta ascendens aneurysm (5 cm), a 4-cm aneurysm of a retroaortic venous saphenous graft was identified, which led to the first posterolateral branch. Surgical exclusion, CABG and aorta ascendens replacement were performed. The patient recovered early and remained asymptomatic over 13 months of follow-up. As far as imaging studies are concerned CT-angiography with or without three-dimensional reconstruction appears as a useful diagnostic measure in defining saphenous graft aneurysms w3, 4x. Notably, even internal mammary artery graft aneurysms may become evident as reported w5x. A 59-year-old male patient presented with a pulsating mass at the left sternal edge weeks after a CABG procedure. CT showed a false aneurysm of the left internal mammary artery (LIMA), confirmed by angiography. The leakage was treated using a 16-by-3.5-mm Jostent leading to complete lesion thrombosis. A large saphenous vein graft aneurysm one year after coronary artery bypass graft surgery presenting as a left lung mass. We read with great interest the article from Abbasi et al. w1x concerning a large saphenous vein graft aneurysm (SVGA) one year after coronary artery bypass grafting (CABG) surgery and we would like to congratulate them for their successful result. Even though reoperative coronary bypass surgery is very frequent today, we do not see a lot of venous aneurysms from previous grafts. However, it has …

eComment: Surgical technique can prevent saphenous vein wall damageduring coronary artery bypass graft surgery