Table 1.
Reports of inadvertent attachment of a bypass graft to a cardiac vein.
| Author | Patient | Symptoms/onset after CABG | Murmur | Graft/Intended Artery/Actual Anastamosis | Shunt | Hemodynamics | CABG | Previous MI | Treatment |
|---|---|---|---|---|---|---|---|---|---|
| Vieweg [1] | 53 M | CHF/6 weeks | Continuous 2nd LICS | SVG/LAD/anterior cardiac vein | Shunt by hydrogen inhalation; normal pulse ox | Mild elevation of right heart pressures | First | No | Graft removal; regrafting of SVG to LAD |
| Lawrie et al. [2] | 44 M | Angina pectoris; <3 months | Systolic; base to neck | SVG/LAD/LAD vein | Not mentioned | Not mentioned | Third | No | Graft ligation; SVG to LAD |
| Treistman et al. [3] | 55 M | SVT, palpitations, syncope; 3.5 years | Continuous 3rd LICS | SVG/LAD/anterior interventricular vein | Normal oximetry | Mild elevation of right heart pressures | First | Anterolateral MI | None |
| Klinke et al. [4] | 40 M | Angina pectoris; 5 months | Not mentioned | SVG/LAD/anterior interventricular vein | Coronary sinus 02 saturation 90% | Normal | First | No | CABG |
| Starling et al. [5] | 47 M | None reported. Anterior ischemia; 3 weeks | Continuous 2nd LICS to apex | SVG/LAD/anterior cardiac vein | None | Normal | First | Posterolateral MI | Fistula ligation; SVG to diagonal |
| Starling et al. [5] | 66 M | Asymptomatic | Continuous 2nd and 3rd LICS to the apex | SVG/proximal LAD to distal LAD/anterior cardiac vein distal LAD | None | Normal | First | Anteroseptal MI | Observation |
| Grollman Jr. et al. [6] | 52 M | Fatigue, dyspnea; 1 year | None | SVG/anterolateral branch of Cx/anterior interventricular vein | 1.1 : 1 | RVEDP 8 mmHg LVEDP 25 mmHg | First | Anteroapical MI | Percutaneous occlusion of SVG with 2 coils |
| Hubert et al. [7] | 55 M | CHF, VT; 1 month | Continuous ULSB | SVG/LV branch of RCA PL of Cx/LV branch posterior interventricular vein | Normal oximetry | RA 20 mmHg | First | Inferior MI | Ligation of fistula |
| Przybojewski [8] | 43 M | Angina pectoris; 10 days | Continuous 2nd and 3rd LICS | SVG/LAD/LAD vein | Not mentioned | Not mentioned | First | Anterolateral MI | Ligation; repeat CABG |
| Goldbaum et al. [9] | 53 M | Angina pectoris, exertional dyspnea; 4 years | None | SVG/LAD/anterior interventricular vein | Small; not quantified | PA 42/19 LVEDP 19 | First | Anterior MI | PTCA of LAD; percutaneous occlusion of SVG with coils |
| Ross and Jang [10] | 44 M | Anginal pectoris; onset not mentioned | Systolic; ULSB | SVG/intermediate or Cx/left marginal vein | 1.4 : 1 | Normal | Second | Inferior MI | None reported |
| Jost et al. [11] | 57 M | Angina pectoris; 2 years | Not mentioned | SVG/LAD/anterior cardiac vein | 18% of pulmonary flow | Not mentioned | First | No | Embolization with silicone balloon |
| Graeb et al. [12] | 56 F | Angina pectoris; 1 year | Not mentioned | SVG/PDA/PDV | Small | Normal | First | No | Balloon embolization of PDA (unsuccessful) |
| Marin-Neto et al. [13] | 57 M | Dyspnea, chest pain; 1 month (no ischemia detected) | Systolic; pulmonic area | SVG/first diagonal/anterior cardiac vein | 23% of pulmonary flow | Normal | First | Inferior MI | None |
| Marin-Neto et al. [13] | 84 M | Angina pectoris; 14 months | Not mentioned | SVG/first diagonal/anterolateral coronary vein | 12% of pulmonary flow | Not mentioned | First | No | PTCA of new RCA lesion, no treatment of fistula |
| Scholz et al. [14] | 49 M | Angina pectoris 15 months | Systolic ULSB | SVG/OM1, OM2/OM1, coronary vein | Small | Normal | First | No | Observation |
| Calkins Jr. et al. [15] | 51 F | Angina pectoris; 2-3 months | None | SVG/OM1, OM2/OM1 coronary vein | None | RV 55/15 PA 55/17 | Second | No | Coil embolization |
| De Marchena et al. [16] | 73 M | Diminished exercise capacity, dyspnea; 2 months | None | LIMA/LAD/great cardiac vein | Small | RV 68/12 RA 12 mmHg | First | No | Observation |
| Khunnawat et al. [17] | 75 F | Dyspnea; 10 years | S3, no murmur | SVG/RCA/cardiac vein | Not mentioned | Not mentioned | First | LBBB on EKG | Not mentioned |
| Khunnawat et al. [17] | 57 M | Dyspnea; 6 years | None | LIMA/LAD/LAD cardiac vein | Not mentioned | Not mentioned | First | Not mentioned | Not mentioned |
| Maier et al. [18] | 50 M | Dyspnea and Angina pectoris; 2 years | Systolic murmur at ULSB | SVG/D1/coronary vein | Large left to right | Pulmonary C.O. 6.6 L/mm, systemic CO 4.8 L/mm, normal pulmonary pressures |
First | Not mentioned | PTCA; failed percutaneous coil embolization led to percutaneous transcatheter detachable balloon of SVG to D1 |
| Patterson et al. [19] | 67 M | angina Pectoris; 7 months | Not mentioned | LIMA-RIMA/PL/PL vein | Present | Not mentioned | First | Not mentioned | PCI to revascularize Cx; then coil embolization of RIMA |
| Sheiban et al. [20] | 73 M | Positive stress test and angina with exertion; 2 months | Not mentioned | LIMA/LAD/GCV | Present “arteriovenous steal” Moderate L-R Shunt | Not mentioned | First | No | PCI with DES of LAD and PCI with covered stent of GCV through coronary sinus |
| Hmem et al. [21] | 76 M | Dyspnea, LE edema, CHF/RHF; 2 months | None | LIMA/LAD/LIMA/cardiac vein | Not mentioned | Not mentioned | First | AS Q waves | Coil embolization to proximal LIMA |
| Lopez et al. [22] | 74 M | Rest angina; 3 months | Not mentioned | SVG-OM2-OM3/SVG-L marginal vein of OM3 | No significant left to right shunt | Not mentioned | Second | Not mentioned | PCI, embolization of marginal vein |
| Braun et al. [23] | 58 M | Angina; 6 months | Not mentioned | LIMA/LAD/LIMA/cardiac vein | Not mentioned | Not mentioned | Second | Not mentioned | RCA-PTCA; coil embolization |
| Deligonul et al. [24] | 66 M | Asymptomatic | None | LIMA/LAD/anterior interventricular vein | Small | None | First | No | Spontaneous closure |
| Deligonul et al. [24] | 57 M | Asymptomatic | None | LIMA/LAD/anterior interventricular vein | Small | None | First | No | Spontaneous closure |
| Miranda et al. [25] | 66 M | Angina; 2 weeks | Not mentioned | LIMA/LAD/anterior interventricular vein | Small | Pulmonary artery pulse ox 66% | Second | No | PTCA to diagonal branch graft followed by balloon occlusion of fistula |
| Peregrin et al. [26] | 54 M | Unstable angina; 1 year | Systolic/diastolic left parasternal | Graft/diagonal branch/graft vena cordis magna | Not mentioned | Not mentioned | First | Inferior MI | PTCA of RCA and balloon occlusion of AV fistula |
| Cardoso [27] | 55 F | Angina | Continuous second left intercostals space | SVG/LAD/LAD vein | Aortic oxygen saturation 92%, coronary sinus saturation 80%, SVC saturation 73% | LV 171/19, RV 43/12, mean PCWP 21 | First | No | Not mentioned |
| White et al. [28] | 56 M | Angina and troponin elevation; 5 years | Not mentioned | LCX-vein graft-marginal/LCX-coronary sinus | None | None | First | No | MRI; coil embolization |
| Thomas et al. [29] | 76 M | Angina with exertion; 3 months | Not mentioned | LIMA/LAD/AIV | Not mentioned | Not mentioned | First | Not mentioned | PCI with stenting and PCI with embolization |
| Mukhopadhyay et al. [30] | 60 M | Exertional angina | Not mentioned | LIMA/LAD/cardiac vein | Left to right shunt | RH and PA pressures normal, 02 sat was 84% on step up in coronary sinus and 72% in the RA to 80% in PA | First | Not mentioned | PCI with failed coil embolization, deferred to surgical correction |
| Jung et al. [31] | 50 M | Asymptomatic | Not mentioned | LIMA/LAD/GCV | Not mentioned | ECHO showed LV hypokinesis and LV systolic dysfunction. | First | Not mentioned | CT angiogram; PCI/DES and Coil embolization |
| Current Case | 69 M | Angina with exertion left arm radiation; 3 months | None | LIMA/LAD/LIMA/cardiac vein | None | Aorta 119/54, mean 77, LV systolic: 130, LVEDP: 14, LV-angiography EF = 55% | First | No | PCI/DES and coil embolization to LIMA |