Aortic rupture caused by fungal aortitis: successful management after heart transplantation.
A 26-year-old man with end-stage idiopathic cardiomyopathy was supported with a Pierce-Donachy left ventricular assist device for 31 days before orthotopic heart transplantation. Fungal endocarditis was discovered at the time of recipient cardiectomy, and antifungal therapy was begun. Fungal mediastinitis developed 4 days after transplantation and was treated with mediastinal irrigation. Massive mediastinal hemorrhage caused by fungal aortitis occurred on two occasions and was successfully treated with a bovine pericardial patch. The patient is well 9 months after transplantation.
Oaks
T E
TE
Department of Surgery, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey 17033.
Pae
W E
WE
Pennock
J L
JL
Myers
J L
JL
Pierce
W S
WS
D000328:Adult; D001019:Aortic Rupture / Q000209:etiology* / Q000601:surgery; D001025:Aortitis / Q000150:complications*; D002177:Candidiasis / Q000150:complications*; D016027:Heart Transplantation; D006353:Heart-Assist Devices / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D008477:Mediastinal Diseases / Q000209:etiology / Q000601:surgery; D008480:Mediastinitis / Q000209:etiology / Q000601:surgery