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Perigraft abscess after DeBakey type-1 aortic dissection: a case report
Lingling Xu1,2, Shan Lin1,2, Yali Yang3,4
1Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Background:
Perigraft abscess is a rare condition which constitutes a small proportion of aortic graft infection (AGI). Early diagnosis is very important for timely intervention and improving the survival rate of patients because of its significant morbidity and mortality.
Case Presentation:
A 24-year-old young male patient with a history of complicated total arch replacement using elephant trunk technique for acute DeBakey type-1 aortic dissection 6 months before visited our hospital with the chief complaint of persistent fever. Antibiotic treatment in local hospital was ineffective. Echocardiography showed liquid dark area around the aortic graft, and a computerized tomography angiography (CTA) was done for further evaluation of periaortic fluid collection which showed findings to suggest perigraft abscess. The patient underwent surgical debridement of the abscess and was found to have an abscess around the aortic graft which was drained followed by antibiotic treatment. The patient was discharged to his local hospital and recovered well at 2 month follow-up appointment.
Conclusion:
This is a very rare case of aortic abscess around the graft that could successfully be managed by graft-conserving surgery, and it emphasizes the significance of early diagnosis of perigraft abscess in patients with aortic dissection surgery.
Insights
A rare perigraft abscess in a young male after aortic dissection surgery was successfully treated with graft-conserving surgery. Early diagnosis and intervention are crucial for improving patient outcomes in aortic graft infections.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Diagnostic Imaging
Background:
- Perigraft abscess is a rare but serious complication of aortic graft infection (AGI).
- Prompt diagnosis and intervention are critical for reducing morbidity and mortality associated with AGI.
- This case highlights a rare presentation of perigraft abscess following complex aortic surgery.
Observation:
- A 24-year-old male presented with persistent fever six months post-total arch replacement for acute DeBakey type-1 aortic dissection.
- Initial antibiotic treatment was ineffective.
- Echocardiography revealed periaortic fluid collection, and CT angiography confirmed findings suggestive of a perigraft abscess.
Findings:
- The patient underwent successful surgical debridement and drainage of the periaortic abscess.
- The aortic graft was conserved during the procedure.
- Post-operative antibiotic treatment led to a favorable recovery.
Implications:
- Graft-conserving surgery can be a viable option for managing perigraft abscesses.
- This case underscores the importance of early diagnosis of perigraft abscess in patients with a history of aortic dissection surgery.
- Timely identification and management are key to successful outcomes in complex aortic graft infections.
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