[A successful case report of redo composite graft and total aortic arch replacement for active prosthetic graft...

A successful redo composite graft and total aortic arch replacement for active prosthetic graft endocarditis is reported in the 31-year-old female with Marfan syndrome who had undergone Bentall procedure and proximal aortic arch replacement for type A acute aortic dissection 21 months previously. Echocardiography revealed massive vegetation in the composite graft and left ventricular outflow tract, and blood culture suggested Candida endocarditis. The composite graft and arch grafts were completely removed, and the reconstruction was carried out with a new composite graft using Piehler's technique. Finally, the total aortic arch was replaced and the all branches were reconstructed. The post-operative course has been uneventful, and she is now doing well 12 months after the operation without any evidence of recurrence of endocarditis.