Mycotic Aortic Pseudoaneurysm in Zone Zero-Zero After Hybrid Therapy

Ascending aorta mycotic pseudoaneurysms are an uncommon condition. The best treatment is controversial, including surgical treatment, endovascular treatment, or a combination of both.

A 44-year-old man was admitted to our hospital with history of a type B aortic dissection 1 year ago. He was successfully treated with hybrid therapy, aortic cerclage, and carotid bridge plus endoprosthesis implantation. During his follow-up, an ascending aorta mycotic pseudoaneurysm was documented by computed tomography scan. Two-stage hybrid therapy with brachiocephalic trunk debranching and a zone zero thoracic endovascular repair (TEVAR) were then successfully performed.

Endovascular repair as emergency therapy for aorta or aortic graft infection is feasible and may well serve as a definite treatment option in selected cases, as high surgical risk patients.

It is possible to perform endovascular repair of mycotic aortic aneurysm as a late complication of TEVAR of aortic type B dissection.