冠状动脉搭桥术后36年出现纵隔肿物：静脉移植物假性动脉瘤是否为鉴别诊断之一？

Mediastinal mass presented 36 years after coronary bypass grafting: is vein graft pseudoaneurysm a differential diagnosis?

作者信息

Elgharably Haytham, Kursbaum Andres, Flamm Scott D, Navia Jose L

机构信息

Department of Thoracic and Cardiovascular Surgery, Heart and Vascular Institute, Cleveland, OH, USA.

Cardiovascular Imaging Laboratory, Imaging Institute and Cardiovascular Medicine, Cleveland, OH, USA.

出版信息

Eur J Cardiothorac Surg. 2015 Jul;48(1):166-8. doi: 10.1093/ejcts/ezu342. Epub 2014 Sep 25.

DOI:10.1093/ejcts/ezu342

PMID:25256826

Abstract

Saphenous vein graft aneurysm is a relatively rare but serious complication of coronary artery bypass grafting (CABG). The diagnosis of such cases is clinically challenging and requires a high index of suspicion, especially if presented atypically or very late after CABG. Herein, we report a case of a saphenous vein graft pseudoaneurysm that presented 36 years after CABG and was masquerading as a right atrial myxoma on serial echocardiograms over a 2-year follow-up period.

摘要

大隐静脉移植血管动脉瘤是冠状动脉旁路移植术（CABG）相对罕见但严重的并发症。此类病例的诊断在临床上具有挑战性，需要高度的怀疑指数，尤其是在表现不典型或CABG术后很晚才出现时。在此，我们报告一例大隐静脉移植血管假性动脉瘤病例，该病例在CABG术后36年出现，在2年的随访期间，连续超声心动图检查一直误诊为右心房黏液瘤。