Saphenous vein graft pseudoaneurysm mimicking septic false aneurysm of thoracic aorta

Saphenous vein graft aneurysm or pseudoaneurysm, and thoracic aortic false aneurysm are rare, but potentially lethal complications of cardiac surgery. We report a case of a 63 year old man who presented 5 years after coronary artery bypass grafting with a chronically discharging sternal wound. A thoracic computerized tomogram revealed a large aortic false aneurysm, presumed to be infective from the clinical scenario. Subsequently, this was shown at operation to be a non-infected thrombosed saphenous vein graft pseudoaneurysm. Definitive confirmation of a non-infective pathology prior to surgery could have prompted non-surgical management with radiological intervention.