A CABG Complication - LIMA Graft to Cardiac Venous System Anastomosis Rescued by Percutaneous Coronary Intervention

• Published in: Cardiovascular revascularization medicine 2023-08, Vol.53, p.S230-S234
• Main Authors: Ghumman, Ghulam Mujtaba, Shah, Jay, Ahsan, Muhammad, Luthra, Kritika, Khan, Amir, Al-Dabbas, Ma'en, Khan, Behram, Taleb, Mohammed, Ali, Syed Sohail, Kabour, Ameer
• Format: Article
• Language: English
• Subjects: Coronary sinus; Inadvertent graft anastomosis; Left internal mammary artery graft; Multivessel coronary artery disease
• ISSN: 1553-8389; 1878-0938
• DOI: 10.1016/j.carrev.2022.05.034

Inadvertent graft anastomosis to the great anterior cardiac vein is a known but rare complication of coronary artery bypass graft surgery (CABG). This is usually managed with percutaneous embolization of the inadvertently anastomosed graft with stenting of underlying atherosclerotic coronary artery disease (CAD) or by surgical correction. We present a similar case of the inadvertent left internal mammary artery (LIMA) graft anastomosis to the cardiac venous system, managed with the less complicated percutaneous coronary intervention of the underlying coronary artery disease due to anginal symptoms without the need for surgical correction or embolization of the graft. •The inadvertent graft anastomosis to the great anterior cardiac vein is a known but rare complication of CABG•The correct identification of the coronary arteries with inspection and palpation during surgery can prevent this complication•The surgical correction or percutaneous embolization of the iatrogenic graft has been performed historically in suitable candidates•Surgically poor candidates can be managed with the percutaneous coronary intervention of the underlying coronary artery disease