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Mycotic aortic arch aneurysm coexistent with constrictive pericarditis: is surgery a dangerous resort?

Peter S Y Yu1, Simon C H Yu2, Cheuk-Man Chu2

  • 1Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.

Journal of Thoracic Disease
|September 14, 2016
PubMed

Insights

A Salmonella infection led to constrictive pericarditis and a mycotic aneurysm in an elderly patient. A hybrid surgical approach combining pericardiectomy with endovascular repair proved feasible and effective.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases
  • Medical Case Reports

Background:

  • Constrictive pericarditis and mycotic aneurysms are serious conditions.
  • Salmonella infections can lead to severe cardiovascular complications.

Observation:

  • An elderly male presented with fever and Salmonella infection, complicated by constrictive pericarditis and a mycotic aortic arch aneurysm.
  • A hybrid treatment strategy was employed, involving open pericardiectomy and aortic debranching, followed by thoracic endovascular stent grafting.
  • The patient received prolonged antibiotic therapy, leading to normalization of inflammatory markers.

Findings:

  • The hybrid surgical approach was technically feasible and resulted in a good outcome.
  • Mid-term follow-up showed no signs of endoleak or fistulation on computed tomography (CT) scans.
  • The patient remained well two years post-operation.

Implications:

  • This case highlights the successful application of a hybrid treatment for complex cardiovascular pathology secondary to infection.
  • The described approach offers a viable alternative to traditional open repairs, potentially reducing the need for deep hypothermic circulatory arrest.
  • This strategy may be associated with satisfactory mid-term outcomes in select patient populations.
Keywords:
Aneurysmendovascular procedurespericardium

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