Giant saphenous vein graft pseudoaneurysm to right posterior descending artery presenting with superior vena cava syndrome

Figure 4 Intraoperative echocardiography showed superior vena cava compression by the giant pseudoaneurysm cranial lobe. A: Intraoperative transesophageal echocardiogram demonstrated normal left ventricular systolic function with left ventricular ejection fraction 60% and the giant pseudoaneurysm of SVG to RPDA in relation to the cardiac structures; B: Echocardiographic view of the pseudoaneurysm upper lobe compressing the superior vena cava (SVC); C, D: Blood flow by color Doppler of the SVC into the right atrium; E, F: Bidirectional flow is seen between the upper and lower pseudoaneurysm (PsA) lobes during diastole and systole respectively. Color Doppler and flow velocities of the giant pseudoaneurysm caudal lobe. RPDA: Right posterior descending artery.