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European Heart Journal Advance Access originally published online on September 25, 2006
European Heart Journal 2007 28(7):787; doi:10.1093/eurheartj/ehl280
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© The European Society of Cardiology 2007. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Inadvertent grafting of the posterior cardiac vein during coronary artery bypass graft surgery

Uygar Cagdas Yuksel*, Turgay Celik and Atila Iyisoy

Department of Cardiology, Gulhane Military Medical Academy, Gulhane School of Medicine, 06018 Etlik-Ankara, Turkey

* Corresponding author. Tel: +90 312 3044268; fax: +90 312 3044250. E-mail address: ucyuksel{at}yahoo.co.uk

A 74-year-old male patient who had a coronary artery bypass graft (CABG) surgery 14 years ago underwent coronary angiography for pre-operative evaluation for non-cardiac surgery. He was reported to have a left internal thoracic artery (LITA) graft to the left anterior descending coronary artery and a saphenous vein graft sequentially to the first and second obtuse marginal arteries. The coronary angiogram revealed a patent LITA graft. As the saphenous vein graft is engaged, the injection revealed simultaneous opacification of the obtuse marginal artery and the coronary sinus, which indicates inadvertent grafting of the posterior cardiac vein instead of the first obtuse marginal artery (Panel A, white arrow). The vein graft was then anastomosed sequentially to the second obtuse marginal. The left anterior oblique projection revealed retrograde opacification of the middle cardiac vein (Panel B, black arrow). As the patient was asymptomatic and no objective signs of ischaemia were found by non-invasive testing, we did not attempt any further intervention.

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This Article
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28/7/787    most recent
ehl280v1
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