Abstract
Background Bleeding from bypass anastomosis leakage occurs early after coronary artery bypass
grafting. Later, once the anastomosis is covered by intima, spontaneous bleeding is
unlikely.
Case Description A 63-year-old male patient developed a pseudoaneurysm-like, subepicardial late-term
bleeding resulting in a hematoma that compromised coronary artery flow by increasing
extracoronary pressure. This resulted in severe angina pectoris (Canadian Cardiovascular
Society IV) and myocardial ischemia within the affected area. After surgical removal
of the hematoma and repair of the anastomosis, the patient's symptoms disappeared
and no signs of myocardial ischemia were present.
Conclusion Surgical removal is an efficient therapy for subepicardial hematoma inducing myocardial
ischemia.
Keywords
complication - myocardial ischemia - hematoma - coronary artery bypass grafting -
CABG
