Related Experiment Video
Updated: Aug 28, 2025
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Successful drainage of periaortic graft abscess and transcatheter aortic valve replacement in the same setting-A
Ahmed S Nasser1, Osama El Khateeb2, Keir Stewart3
1Dalhousie Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Presentation:
81-year-old man with a history of Bio-Bentall surgery presented to the emergency department with fever, chills and back pain. Initial physical examination was inconclusive apart from sudden onset of delirium.
Investigation:
Elevated white blood cells, anemia, and neutrophilia. Further studies revealed gram-positive cocci on the initial blood culture, which was then confirmed to be Methicillin Sensitive Staph Aureus bacteremia. Subsequently, a transesophageal echocardiography showed a periaortic abscess, moderate aortic regurgitation and severe aortic stenosis with no evidence of endocarditis.
Management:
Antibiotics were started and urgent abscess drainage was planned. In a hybrid operative setting, a multidisciplinary team of cardiology, and cardiac surgery managed the periaortic graft abscess drainage through a median sternotomy and transcatheter aortic valve replacement. Postoperatively, the complications included bradycardia, and right heart failure. Six-week course of IV Rifampin, Probenecid, and Cefazolin was initiated, and patient was to remain on lifelong Cefadroxil.
Conclusion:
A hybrid approach should be considered for patients with high morality risks in the field of cardiovascular medicine as it offers the best available combination of treatments.
