Mycotic Aneurysm of Distal Aortic Arch, after Total Arch Replacement with Open-stent Graft;Report of a Case

The patient was a 72-year-old man, who had undergone total arch replacement with an open-stent graft due to saccular aneurysm of distal arch, 2 years before. He was admitted to a local hospital with the complaint of high fever, and was diagnosed as having pyothorax, after computed tomography (CT) sc...

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Published inKyobu geka. The Japanese journal of thoracic surgery Vol. 68; no. 5; p. 387
Main Authors Suzuki, Kotaro, Kawahara, Yu, Masaki, Naoki, Kobayashi, Yuriko, Takahara, Shingo, Nakamura, Ken, Toyama, Shuji, Fukasawa, Manabu
Format Journal Article
LanguageJapanese
Published Japan 01.05.2015
Subjects
Aged
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - diagnosis
Aortic Aneurysm, Thoracic - microbiology
Aortic Aneurysm, Thoracic - surgery
Cardiopulmonary Bypass
Humans
Imaging, Three-Dimensional
Male
Stents
Sternotomy
Thoracotomy
Tomography, X-Ray Computed
Vasculitis - complications
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Summary:The patient was a 72-year-old man, who had undergone total arch replacement with an open-stent graft due to saccular aneurysm of distal arch, 2 years before. He was admitted to a local hospital with the complaint of high fever, and was diagnosed as having pyothorax, after computed tomography (CT) scanning. After transferred to our hospital, he was treated by drainage, and antibiotic therapy. But CT scans showed the enlargement of distal arch aneurysm, and migration of the stent graft. Urgent operation was performed. We approached to the site by a full sternotomy, and left anterolateral thoracotomy. Segment 1+2 of the left lung was resected to avoid bleeding and lung injury. Graft replacement of distal arch and descending aorta was performed on cardiopulmonary bypass, with hypothermia, selective brain perfusion and systemic circulatory arrest. To protect from recurrence of infection, the omental flap was transposed to the graft site. Until now, there is no recurrence of infection.
ISSN:0021-5252