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En bloc resection and extended replacement of the infected aortic arch

Toshinori Totsugawa1, Hiroki Takiuchi, Masahiko Kuinose

  • 1Department of Cardiovascular Surgery, Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Kita-ku, Okayama 700-0823, Japan. toshinoritotsugawa@mac.com

General Thoracic and Cardiovascular Surgery
|June 16, 2011
PubMed

Insights

En bloc resection and replacement with a rifampicin-bonded graft is a key technique for infected aortic arch aneurysms. This surgical approach addresses impending rupture, improving patient outcomes in complex cases.

Area of Science:

  • Cardiovascular Surgery
  • Vascular Surgery
  • Infectious Disease Management

Background:

  • Infected aortic arch aneurysms pose a critical surgical challenge due to rupture risk.
  • Emergent surgical intervention is often required for hemodynamic instability.

Observation:

  • A 74-year-old male presented with an infected aortic arch aneurysm at risk of rupture.
  • The surgical approach involved median sternotomy and left thoracotomy.

Findings:

  • En bloc resection of the infected aortic arch was performed under circulatory arrest with selective cerebral perfusion.
  • Replacement utilized a rifampicin-bonded prosthetic graft, with omental flap coverage for the prosthesis and anastomoses.

Implications:

  • En bloc resection is a crucial technique for managing infected aortic aneurysms.
  • Rifampicin-bonded grafts may reduce the risk of graft infection.
  • This approach highlights the importance of specialized techniques in complex aortic pathology.

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