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Mycotic pseudoaneurysm of the ascending aorta after mediastinitis in an infant

Kagami Miyaji1, Nobuhiro Nagata, Hikoro Matsui

  • 1Department of Cardiovascular Surgery, Kanagawa Children's Medical Center, Yokohama, 2-138-4 Mutsugawa, Minami-ku, Yokohama, Japan. kagami111@aol.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery
|September 26, 2002
PubMed

Insights

A rare pediatric aortic mycotic pseudoaneurysm after a Fontan procedure was successfully repaired. The surgical repair using an autologous pericardial patch showed no recurrence after six months.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Infectious Diseases

Background:

  • Mycotic pseudoaneurysm of the aorta is a rare but serious complication, particularly in pediatric patients.
  • Postoperative mediastinitis following complex cardiac surgeries like the modified Fontan procedure can lead to aortic pseudoaneurysm formation.

Observation:

  • This report details a case of a pediatric patient who developed a mycotic pseudoaneurysm of the ascending aorta.
  • The pseudoaneurysm was a direct consequence of mediastinitis occurring after a modified Fontan procedure.

Findings:

  • Successful surgical repair of the ascending aortic pseudoaneurysm was achieved using an autologous pericardial patch.
  • The repair was performed via a right thoracotomy approach under conditions of total circulatory arrest.
  • Postoperative follow-up for six months revealed no evidence of pseudoaneurysm recurrence, indicating a favorable outcome.

Implications:

  • This case highlights a viable surgical strategy for managing rare mycotic aortic pseudoaneurysms in children post-Fontan procedure.
  • The use of autologous pericardial grafts offers a potential solution for complex aortic reconstructions in pediatric cardiac surgery.
  • Effective management of mediastinitis and early detection of pseudoaneurysms are crucial for improving outcomes in these high-risk patients.

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