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Archives of Cardiovascular Disease (2013) 106, 457—459
Available online at
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Internal thoracic artery pseudoaneurysm aftercoronary artery bypass
Pseudo-anévrisme de l’artère thoracique interne après pontage aorto-coronaire
Mi Hyoung Moon, Keon Hyun Jo, Hwan Wook Kim ∗
Department of Thoracic and Cardiovascular Surgery, Seoul Saint-Mary’s Hospital, School ofMedicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, Republic ofKorea
Received 25 October 2011; received in revised form 4 November 2011; accepted 14 November2011
Available online 13 April 2012KEYWORDSEmbolization;Internal thoracicartery;Minimally invasivecoronary artery
Left internal thoracic artery (LITA) pseudoaneurysm after coronary artery bypass graft is arare complication. We report a case of LITA pseudoaneurysm after minimally invasive directcoronary artery bypass (MIDCAB) in a 79-year-old man who developed severe respiratorydistress caused by haemoptysis.
The patient had a medical history of pneumoconiosis. One year earlier, he had a MID-CAB through a left mini-anterolateral thoracotomy for left anterior descending coronaryartery stenosis. An emergency thoracic computed tomography scan showed an intratho-
bypass;Pseudoaneurysm
MOTS CLÉSEmbolisation ;Artère thoraciqueinterne ;Pseudo-anévrisme ;Pontageaorto-coronairemini-invasif
racic pseudoaneurysm of the LITA, 4.3 cm in maximal diameter, compressing the adjacentlung parenchyma (Fig. 1B, C). An emergency left subclavian arteriogram showed a fusiformpseudoaneurysm of the LITA, connecting with the bronchial artery via multiple collateralvessels (Fig. 1D).
Abbreviations: LITA, left internal thoracic artery; MIDCAB, minimally invasive direct coronary artery bypass.∗ Corresponding author. Fax: +82 2 594 8644.
E-mail address: [email protected] (H.W. Kim).
1875-2136/$ — see front matter. Published by Elsevier Masson SAS.doi:10.1016/j.acvd.2011.11.008
458 M.H. Moon et al.
Figure 1. Internal thoracic artery pseudoaneurysm before embolization. A. Chest X-ray showing bilateral patchy densities and honeycombappearance attributable to pneumoconiosis. B, C. Contrast-enhanced thoracic computed tomography (CT) scan images. D. Left subclavianangiogram. B—D. White arrows indicate the pseudoaneurysm and yellow arrows indicate the left internal thoracic artery. D. Black arrowsindicate multiple collateral vessels.
Figure 2. Thrombosed and excluded pseudoaneurysm after endovascular embolization. A. Chest X-ray showing multiple coils along theinternal thoracic artery. B, C. Contrast-enhanced thoracic computed tomographic scan showing that the left internal thoracic artery isnot seen after embolization (white arrows indicate completely thrombosed pseudoaneurysm). D. Completion angiogram after embolizationshowing successful exclusion of the pseudoaneurysm from the internal thoracic artery.
wi
IInternal thoracic artery pseudoaneurysm after CABG
First, percutaneous coronary stenting was done for theleft anterior descending artery lesion. Next, endovascu-lar coiling for the LITA pseudoaneurysm was performed.The completion angiogram showed successful exclusion
of the LITA pseudoaneurysm (Fig. 2D). A follow-upcomputed tomography scan showed successful throm-bosis of the LITA pseudoaneurysm (Fig. 2C, D). Thepatient was discharged on the seventh postprocedural dayD
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ithout haemoptysis or any other symptoms of myocardialschaemia.
isclosure of interest
he authors declare that they have no conflicts of interestoncerning this article.
