Case report: Unusual presentation of haemopericardium with haemodynamic instability secondary to a coronary graft pseudoaneurysm treated by an endovascular approach

Background: We report the successful endovascular treatment of a coronary graft pseudoaneurysm using a technique often seen in intracranial aneurysm coiling.

Case summary: We present an unusual case of a patient who presents with haemopericardium and haemodynamic instability after saphenous vein bypass grafting. A pseudoaneurysm rapidly expanded from 5 cm to 7 cm over the follow-up period producing compressive mass effect on the lateral right ventricle with transient haemodynamic instability. The patient's declining clinical condition did not warrant a redo thoracotomy and sternotomy, so an endovascular approach was deemed to be the best treatment option.

Discussion: The use of endovascular embolization techniques is indeed a technically viable alternative with positive outcomes without the need for thoracotomy and sternotomy.