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Multiple mycotic arch-thoraco-abdominal aortic aneurysms: a successful case of in situ graft replacement
S Kuki1, K Taniguchi, S Miyagawa
1Department of Cardiovascular Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai, Japan. skuki@orh.go.jp
Abstract:
Mycotic aortic aneurysms are an uncommon yet still life-threatening pathology. We report on a 67-year-old male who had a persistent fever and back pain. Contrast enhanced computed tomography (CT) showed multiple aortic aneurysms located in the aortic arch, the descending thoracic aorta and the supraceliac abdominal aorta. After 2 months of antibiotic therapy, a staged operation was carried out with 2-week interval, which includes a graft replacement of aortic arch with elephant trunk technique and a graft replacement of thoraco-abdominal aorta with omental transfer. The postoperative course was uneventful. This case seems to be quite rare in terms of multiplicity and location of mycotic aneurysms. Surgical strategy for this pathology is discussed.
Insights
This case report details a rare instance of multiple, widespread mycotic aortic aneurysms in a 67-year-old male. Successful surgical intervention involved staged graft replacements, highlighting effective treatment strategies for this life-threatening condition.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Radiology
Background:
- Mycotic aortic aneurysms are rare but critical vascular infections.
- Prompt diagnosis and aggressive management are essential for patient survival.
Observation:
- A 67-year-old male presented with persistent fever and back pain.
- Contrast-enhanced computed tomography (CT) revealed multiple aortic aneurysms across the aortic arch, descending thoracic aorta, and supraceliac abdominal aorta.
Findings:
- The patient underwent a 2-month course of antibiotic therapy.
- A staged surgical approach included graft replacement of the aortic arch with an elephant trunk technique and thoraco-abdominal aorta replacement with omental transfer.
- The postoperative recovery was uneventful.
Implications:
- This case highlights a rare presentation of mycotic aortic aneurysms regarding multiplicity and location.
- The successful staged surgical strategy offers valuable insights for managing complex aortic pathologies.
- Effective antibiotic therapy followed by surgical repair is crucial for treating mycotic aortic aneurysms.