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Case Reports
. 2006;33(3):356-8.

Alternative surgical strategy for the treatment of a mycotic aortic arch aneurysm

Sebastian Pagni  1 , Brian L Ganzel, Harvey L Edmonds Jr
Affiliations
Case Reports

Alternative surgical strategy for the treatment of a mycotic aortic arch aneurysm

Sebastian Pagni et al. Tex Heart Inst J. 2006.

Abstract

We report the case of a 69-year-old man who presented with a symptomatic mycotic aneurysm of the aortic arch. Diagnosis was confirmed by positron emission tomography and by blood cultures positive for Salmonella species. A complete resection of the aortic arch process was performed via left thoracotomy using a cryopreserved aortic homograft and normothermic left heart bypass. The left-sided cerebral vessels were clamped, and adequacy of collateral left brain flow and oxygenation was confirmed by neurophysiologic monitoring. Using this less-invasive operative strategy, we avoided the risks inherent to deep hypothermic circulatory arrest and the use of prosthetic materials.

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Figures

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Fig. 1 A) Computed tomography shows the mycotic arch aneurysm with the periaortic process. B) A 3-dimensional reconstruction of the same scan shows the location of the aneurysm in relation to the brachiocephalic artery and left carotid vessels.
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Fig. 2 The completed arch repair shows the reversed, cryopreserved homograft in situ and the anastomoses to the proximal aortic arch and the left subclavian artery.
See this image and copyright information in PMC

References

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