Fungal infection in a dissecting aneurysm of the thoracic aorta.
We describe a 54-year-old man who had an ascending aortic prosthetic graft and a porcine aortic valve prosthesis that were infected by Candida albicans. This infection led to the formation of a dissecting false aneurysm of the remaining transverse and entire descending thoracic aorta, and the man was admitted to our hospital for surgical treatment in February of 1991. Staged in situ graft replacement was performed using Borst's "elephant trunk" repair for the proximal aortic reconstruction and an open distal anastomosis technique for the distal repair. Candida albicans in the residual prosthetic graft was identified, and therapy with high-dose liposomal amphotericin B was initiated. The use of liposomal amphotericin B reduces the incidence of adverse effects and allows administration of higher doses than those possible with conventional amphotericin B therapy. Lifelong antifungal therapy is recommended for patients with C. albicans infection of prosthetic aortic grafts.
Department of Cardiovascular Surgery, Texas Heart Institute, St. Luke's Episcopal Hospital, Houston 77225-0345.
D A
DA
Cooley
C M
CM
Burnett
D000784:Aortic Dissection / Q000000981:diagnostic imaging / Q000601:surgery*; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001021:Aortic Valve / Q000601:surgery; D001027:Aortography; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D002177:Candidiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D016469:Fungemia / Q000000981:diagnostic imaging / Q000601:surgery; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000601:surgery*; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012086:Reoperation; D013536:Suture Techniques
D011093:Polyethylene Terephthalates