Successful preoperative diagnosis and treatment of a saphenous vein coronary artery bypass graft aneurysm.

A 71-year-old man who underwent a coronary artery bypass using a saphenous vein bypass graft (SVG) in 1977 presented with a new mediastinal mass on chest radiography. A variety of imaging techniques were applied and magnetic resonance imaging (MRI) provided excellent anatomic detail of an aneurysm of the previously placed SVG. This condition was successfully treated with repeat operation, aneurysm resection, and placement of new bypass grafts. We recommend that any patient with a history of previous coronary artery grafting who presents with a mediastinal mass be evaluated for the possibility of a graft aneurysm. The best mediastinal imaging technique for this purpose appears to be an MRI scan.