Mycotic Pseudoaneurysm of Saphenous Vein Graft: A Rare Entity Presenting as Myocardial Infarction and Shock
Recommended Citation
Halboni A, Ayyad A, Abdou A, Sukhon F, Villablanca P, Lee J, Kim H, Alaswad K, Apostolou D, Al-Qarqaz M. Mycotic Pseudoaneurysm of Saphenous Vein Graft: A Rare Entity Presenting as Myocardial Infarction and Shock. JACC Case Rep. 2026;31(21):107939.
Document Type
Article
Publication Date
5-27-2026
Publication Title
JACC Case Rep
Abstract
BACKGROUND: Mycotic aortocoronary saphenous vein graft (SVG) aneurysms and pseudoaneurysms are rare, with variable clinical presentations.
CASE SUMMARY: A 73-year-old man with a history of coronary artery bypass surgery 23 years prior presented with lateral ST-segment elevation myocardial infarction and bacteremia. Echocardiography, invasive coronary angiography, and computed tomography angiography identified a large mycotic pseudoaneurysm arising from the vein graft distal anastomosis site to the obtuse marginal artery. Ensuing hemodynamic compromise resulted from mixed septic and cardiogenic shock, requiring mechanical circulatory support followed by surgical ligation and excision of the pseudoaneurysm.
DISCUSSION: Mycotic aneurysms and pseudoaneurysms of the SVG to coronary arteries should be considered in patients with prior coronary bypass surgery presenting with cardiac symptoms and signs of active infection.
TAKE-HOME MESSAGES: Mycotic aneurysms and pseudoaneurysms of the SVG are a rare entity and may occur from extracardiac infectious sources. Multimodality imaging and multidisciplinary team discussion is essential for diagnosis and management.
PubMed ID
41989368
ePublication
ePub ahead of print
Volume
31
Issue
21
First Page
107939
Last Page
107939
