Giant Saphenous Vein Graft Aneurysms in a Patient with Rheumatoid Arthritis: A Case Reportand Review of theLiterature

Rheumatoid arthritis (RA) is the most common society chronic, erosive, autoimmune and inflammatory polyarthritis. Primarily as a joint diseases, but a variety of extra-articular involvement is a systemic disease. Saphenous Vein Graft Aneurysm (SVGA) are rare complications after coronery artery bypass grafting (CABG) and occur predominantly 10 to 20 years after the procedure. We report a case in which a 64-year old man with a history of coronary artery bypass grafting (CABG) 4 years ago and with a diagnosis of RA in remission who is taking methotrexate 10 mg once a week was admitted to hospital because of dyspnea and chest pain that was worsened in the preceding 4 months. The actual development of SVG aneurysm is unclear but known as risk factors include hypertension, saphenous vein graft trauma, hyperlipidemia and smoking. Although our patient was having none of these risk factors, multiple SVG aneurysms reaching large dimensions that have developed in the early period after CABG. We think that degenerative and inflammatory processes due to RA may have accelerated the development of giant SVG aneurysms

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1. Harris ED Jr. Clinical features of rheumatoid arthritis. In: Ruddy S, Harris ED, Sledge CB, eds, Textbook of rheumatology. Philadelphia: WB. Saunders. 2001;967-1000.

2. Memon AQ, Huang RI, Marcus F, Xavier L, Alpert J. Saphenous vein graft aneurysm: case report and review. Cardiol Rev. 2003;11(1):26-34.

3. Benchimol A, Harris CL, Desser KB, Fleming H. Aneurysms of an aorto-coronary artery saphenous vein bypass graft--a case report. Vasc Surg. 1975;9(4):261-4.

4. Vlodaver Z, Edwards JE. Pathologic changes in aortic-coronary arterial saphenous vein grafts. Circulation. 1971;44(4):719-28

5. Liang BT, Antman EM, Taus R, Collins JJ Jr, Schoen FJ. Atherosclerotic aneurysms of aortocoronary vein grafts. Am J Cardiol. 1988;61(1):185-8.

6. Johnson PR, Truitt TD. Saphenous vein coronary artery bypass graft aneurysm demonstrated by electron beam CT scan. J Comput Assist Tomogr. 1994;18(3):488-91.

7. Sugimoto T, Yamamoto K, Yoshii S, Shimada K, Katsu M, Iida Y, Kasuya S. Large saphenous vein graft aneurysm with a fistula to the right atrium. Ann Thorac Cardiovasc Surg. 2006;12(6):435-7.

8. Garcia-Lara J, Pinar-Bermudez E, Hurtado JA, Valdez-Chavarri M. Giant. True saphenous vein graft aneurysm. J Am Coll Cardiol. 2009;54(20):1899.

9. Ramirez FD, Hibbert B, Simard T, Pourdjabbar A, Wilson KR, Hibbert R, et al. Natural history and management of aortocoronary saphenous vein graft aneurysms: a systematic review of published cases.Circulation. 2012;126(18):2248-56.

10. Ennis BM, Zientek DM, Ruggie NT, Billhardt RA, Klein LW. Characterization of a saphenous vein graft aneurysm by intravascular ultrasound and computerized threedimensional reconstruction. Cath and Cardiovasc Diagn. 1993;28(4):328-31
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  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
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