This 72 years old man had a CABG ten years ago with a LIMA-LAD, SVG-D1, and SVG-RCA and SVG-OM. He came for a routine cardiac CT. He did not have any significant symptoms.
The images showed a normal SVG-RCA and LIMA-LAD (FIgs. 1, 2), with an occluded SVG-D1. The SVG-OM showed a severely stenotic lesion in the mid-OM (Fig. 3).
Saphenous vein grafts as against arterial grafts have a higher incidence of complications. In this patient, the SVG-D1 was occluded along with a stenotic lesion in the SVG-OM. The patient however was asymptomatic and refused a stress thallium and any further intervention. His reasoning was that if he did not have symptoms, he did not want any procedure to be performed at all.