[Successful treatment of an infected pseudoaneurysm of the ascending aorta with omental transfer--a case report].
The formation of pseudoaneurysm is an uncommon complication of after coronary artery bypass grafting (CABG). We report a 66-year-old man in whom an anastomotic pseudoaneurysm of the ascending aorta derived from mediastinitis after repeat CABG. At operation, the pseudoaneurysm was revealed to be involved in the proximal anastomotic site of a saphenous vein graft to the RCA. The aneurysm was resected and the defect was repaired with woven dacron patch under deep hypothermic circulatory arrest. In addition, omental transposition was performed to treat mediastinitis radically. Debris of the pseudoaneurysm grew methicillin-resistant Staphylococcus aureus (MRSA), so vancomycin was administered intravenously for 8 weeks. The postoperative course was uneventful. We considered that omental transfer can be very effective in the management of severe mediastinitis, especially that due to an infected pseudoaneurysm or widespread mediastinitis caused by MRSA.
Inoue
T
T
Department of Cardiovascular Surgery, Kinan General Hospital, Wakayama, Japan.
Sato
S
S
Kato
H
H
Sakagoshi
N
N
Inoue
M
M
Takenaka
H
H
D000368:Aged; D017541:Aneurysm, False / Q000382:microbiology / Q000601:surgery*; D000785:Aneurysm, Infected / Q000382:microbiology / Q000601:surgery*; D001014:Aortic Aneurysm / Q000382:microbiology / Q000601:surgery*; D001026:Coronary Artery Bypass; D006801:Humans; D008297:Male; D008480:Mediastinitis / Q000382:microbiology* / Q000601:surgery; D016106:Methicillin Resistance; D009852:Omentum / Q000637:transplantation*; D011183:Postoperative Complications / Q000382:microbiology / Q000601:surgery*; D012086:Reoperation; D013203:Staphylococcal Infections; D013524:Surgical Flaps