Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome


Figure 4 Intraoperative echocardiography showed superior vena cava compression by the giant pseudoaneurysm cranial lobe



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Figure 4 Intraoperative echocardiography showed superior vena cava compression by the giant pseudoaneurysm cranial lobe. A: Intraoperative transesophageal echocardiogram demonstrated normal left ventricular systolic function with left ventricular ejection fraction 60% and the giant pseudoaneurysm of SVG to RPDA in relation to the cardiac structures; B: Echocardiographic view of the pseudoaneurysm upper lobe compressing the superior vena cava (SVC); C, D: Blood flow by color Doppler of the SVC into the right atrium; E, F: Bidirectional flow is seen between the upper and lower pseudoaneurysm (PsA) lobes during diastole and systole respectively. Color Doppler and flow velocities of the giant pseudoaneurysm caudal lobe. RPDA: Right posterior descending artery.
FOOTNOTES

Ethics approval: This is a clinical case report. All patients related identification information has been avoided according to the policy of University of Iowa Hospitals and Clinics and the Health Insurance Portability and Accountability Act (HIPPA) by the United States.

Informed consent: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.

Conflict-of-interest: All authors have no conflict-of interest to disclose.

Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

Peer-review started: January 10, 2015

First decision: January 20, 2015

Article in press: April 2, 2015


P- Reviewer: Ghanem A, Kettering K, Lazzeri C, Sakabe K, Vermeersch P S- Editor: Qi Y L- Editor: A E- Editor: Zhang DN
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