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Vegetation attached to the elephant trunk.

Akiko Tanaka¹, Toshihito Sakamoto, Kenji Okada

¹Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan. akikotanaka623@gmail.com

European Journal of Cardio-Thoracic Surgery : Official Journal of the European Association for Cardio-Thoracic Surgery

|March 27, 2013

Summary

This summary is machine-generated.

A rare graft infection occurred in a patient with thoracic aortic aneurysm repair using the elephant trunk technique. Vegetation on the graft required emergent replacement, resolving the infection.

Keywords:

Aortic dissection Elephant trunk technique Transoesophageal echocardiography Vegetation

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Area of Science:

Cardiovascular Surgery
Thoracic Aortic Aneurysms
Graft Infections

Background:

The elephant trunk technique is a standard surgical approach for extensive thoracic aneurysms.
Type A aortic dissection requires complex repair, often involving aortic arch replacement and graft implantation.
Graft infections following aortic surgery are serious complications.

Observation:

A 36-year-old male presented with high-grade fever, Osler's nodules, and neurological symptoms (emboli/hemorrhages) post-aortic arch repair with elephant trunk graft.
Transesophageal echocardiography revealed vegetation on the distal elephant trunk graft, despite no cardiac chamber infection.
The patient had undergone total arch replacement for type A aortic dissection.

Findings:

A rare case of distal elephant trunk graft infection with vegetation was identified.
Emergent graft replacement was successfully performed to address the infection.
The patient experienced no recurrence of infection post-operatively.

Implications:

This case highlights a rare but critical complication of the elephant trunk technique in aortic aneurysm repair.
Early diagnosis and prompt surgical intervention are crucial for managing graft infections.
Successful graft replacement can lead to favorable outcomes even in complex infectious scenarios.