Early saphenous vein graft aneurysm rupture. A not so-late complication. Case report and comprehensive literature review

first_pagesettingsOrder Article Reprints Open AccessReview Early Saphenous Vein Graft Aneurysm Rupture: A Not So-Late Complication. Case Report and Comprehensive Literature Review by Eleonora Mezzetti 1,Aniello Maiese 1,*,Federica Spina 1ORCID,Fabio Del Duca 2ORCID,Alessandra De Matteis 2,Marco Di Paolo 1,Raffaele La Russa 3ORCID,Emanuela Turillazzi 1 andVittorio Fineschi 2ORCID 1 Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, Section of Legal Medicine, University of Pisa, 56126 Pisa, Italy 2 Department of Anatomical, Histological, Forensic and Orthopedical Sciences, Sapienza University of Rome, Viale Regina Elena 336, 00161 Rome, Italy 3 Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy * Author to whom correspondence should be addressed. Biomedicines 2023, 11(1), 220; https://doi.org/10.3390/biomedicines11010220 Received: 1 December 2022 / Revised: 9 January 2023 / Accepted: 13 January 2023 / Published: 14 January 2023 (This article belongs to the Section Molecular and Translational Medicine) Download Browse Figures Review Reports Versions Notes Abstract Background and Objectives: Saphenous vein graft (SVG) is a cardiac surgical practice used to create a cardiac bypass in cases of coronary artery obstruction. It consists of a surgical procedure that involves the creation of an aorto-coronary communication by a venous conduit (saphenous vein) to bypass coronary stenosis and allow cardiac revascularization. This practice can be affected by early and late complications. The most feared complication is graft aneurysm or pseudoaneurysm degeneration and rupture which are considered late complications. This paper presents a rare case of SVG aneurysmal rupture that occurred 24 h after surgery and a review of the literature to provide a general look at the state of knowledge. Materials and Methods: The systematic review was carried out using the guidelines according to the PRISMA method. Results: Cases of aneurysmal rupture have never been described prior to one month after surgery. The male sex and subjects under 45 are the most affected by this complication. Death occurs in less than half of the cases, being more frequent in young people. Performing a CT or angio-CT examination led to the diagnosis. Conclusions: It is impossible to estimate the implanted vessel’s quality, so postoperative follow-up is fundamental. Transesophageal ultrasound can be useful, and hematochemical tests are valuable early diagnostic tools, whrease CT and angio-CT can be useful even months after surgery. Forensic analysis should always perform an autopsy and graft histological examination.