We report the case of a 52-year-old man who was admitted for atypical thora
cic pain 18 years after a saphenous vein bypass graft of the left anterior
descending coronary artery. Investigations demonstrated an aneurysm of the
middle portion of the vein graft with a fistulous communication to the pulm
onary artery trunk. The aneurysm was excised surgically, and the fistula wa
s closed with an autogenous pericardial patch. (C) 2001 by The Society of T
horacic Surgeons.