Giant Saphenous Vein Graft Aneurysms in a Patient with Rheumatoid Arthritis: A Case Reportand Review of the Literature

Abstract

Rheumatoid arthritis (RA) is the most common society chronic, erosive, autoimmune and inflammatory polyarthritis. Primarily as a joint diseases, but a variety of extra-articular involvement is a systemic disease. Saphenous Vein Graft Aneurysm (SVGA) are rare complications after coronery artery bypass grafting (CABG) and occur predominantly 10 to 20 years after the procedure. We report a case in which a 64-year old man with a history of coronary artery bypass grafting (CABG) 4 years ago and with a diagnosis of RA in remission who is taking methotrexate 10 mg once a week was admitted to hospital because of dyspnea and chest pain that was worsened in the preceding 4 months. The actual development of SVG aneurysm is unclear but known as risk factors include hypertension, saphenous vein graft trauma, hyperlipidemia and smoking. Although our patient was having none of these risk factors, multiple SVG aneurysms reaching large dimensions that have developed in the early period after CABG. We think that degenerative and inflammatory processes due to RA may have accelerated the development of giant SVG aneurysms