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Fatal fungal infection of an ascending aortic graft
1Department of Cardiovascular Surgery, General Hospital Lainz, Vienna, Austria.
Abstract:
In a 57-year-old male with aortic valve stenosis and severe poststenotic dilation of the ascending aorta an aortic valve replacement and interposition of the dilated aortic segment with a Dacron prosthesis were carried out. Perioperative course was uneventful. Four months after dismission the patient presented with septic fever and recurrent arterial emboli. Histological evaluation of the thrombotic material found fungal masses of Aspergillus flavus. Although adequate antimycotic treatment was started immediately the patient died two days later. Postmortem examination revealed massive fungal infection of the Dacron prosthesis while the aortic allograft appeared free from infection. The symptoms of a fungal infection and possible diagnostic strategies are discussed.
Insights
A Dacron prosthesis used for aortic valve replacement became infected with Aspergillus flavus, leading to fatal fungal masses and arterial emboli in a patient. This case highlights the risks of prosthetic graft infection in cardiovascular surgery.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Medical Prosthetics
Background:
- Aortic valve stenosis and ascending aorta dilation necessitate surgical intervention.
- Prosthetic materials like Dacron grafts are used in complex cardiovascular repairs.
Observation:
- A patient developed septic fever and arterial emboli four months post-aortic valve replacement with a Dacron graft.
- Histological analysis revealed Aspergillus flavus fungal masses in thrombotic material.
Findings:
- Postmortem examination confirmed massive fungal infection of the Dacron prosthesis.
- An aortic allograft in the same patient remained uninfected, suggesting graft material susceptibility.
Implications:
- This case underscores the potential for prosthetic graft infection by fungi like Aspergillus.
- Early diagnosis and management strategies for prosthetic graft infections are critical.
- Consideration of alternative graft materials or enhanced infection prevention protocols may be warranted.