Bilateral splenorenal bypass and axillofemoral graft for management of juxtarenal mycotic aneurysm.
The principles of treatment of mycotic aortic aneurysms are not well established and the optimal method of revascularization--extra-anatomic bypass or in situ grafting--is still debated. Infection of the juxtarenal or suprarenal aorta poses an additional challenge in management because of the requirement for visceral revascularization. The case of a 73-year-old man is reported who developed several mycotic aneurysms of the juxtarenal, infrarenal aorta and right main iliac artery following a Candida infection. He was successfully treated with suprarenal aortic ligation, aneurysmal excision, splenorenal bilateral bypass and systemic antifungal therapy. The patient subsequently underwent extra-anatomic revascularization of the lower extremities with a left axillobifermoral bypass involving a polytetrafluoroethylene graft.
Marty-Ané
C
C
Service de Chirurgie Thoracique et Vasculaire, Hôpital Arnaud de Villeneuve, Centre Hospitalier Universitaire, Montpellier, France.
Alric
P
P
Prudhomme
M
M
Picard
E
E
Mary
H
H
D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000601:surgery*; D015901:Angiography, Digital Subtraction; D000935:Antifungal Agents / Q000008:administration & dosage; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000601:surgery*; D001366:Axillary Artery / Q000000981:diagnostic imaging / Q000601:surgery; D001807:Blood Vessel Prosthesis; D002177:Candidiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D003111:Colonic Polyps / Q000601:surgery; D003131:Combined Modality Therapy; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007668:Kidney / Q000098:blood supply*; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D012077:Renal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D013157:Splenic Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014680:Veins / Q000637:transplantation*
D000935:Antifungal Agents