Pseudomonas aeruginosa pseudoaneurysm of the ascending aorta after coronary artery bypass graft surgery.
Mycotic pseudoaneurysms of the ascending aorta are rare in patients undergoing coronary artery bypass graft surgery and are usually caused by Staphylococcus aureus. We describe a patient with a mycotic pseudoaneurysm of the ascending aorta at the proximal vein graft anastomosis site after coronary artery bypass grafting. Cultures from the saphenous vein harvest site and from the aneurysm sac obtained intraoperatively during repair of the pseudoaneurysm grew Pseudomonas aeruginosa. Treatment included femorofemoral bypass and hypothermic circulatory arrest with in situ patch repair. The patient was given ceftazidime and gentamicin intravenously for 2 weeks, then ceftazidime alone for 6 weeks. Thereafter, he began taking ciprofloxacin orally for chronic suppression. He was doing well at 18-month follow-up.
Schmitt
Timothy M
TM
Section of Cardiothoracic Surgery, Mayo Clinic, Jacksonville, Florida 32224, USA.
Finck
Sanford J
SJ
Brumble
Lisa M
LM
Lane
Gary E
GE
D000368:Aged; D017541:Aneurysm, False / Q000382:microbiology*; D000785:Aneurysm, Infected / Q000382:microbiology; D001014:Aortic Aneurysm / Q000382:microbiology* / Q000628:therapy; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006324:Heart Arrest, Induced; D006801:Humans; D008297:Male; D011552:Pseudomonas Infections / Q000175:diagnosis* / Q000628:therapy; D012501:Saphenous Vein / Q000637:transplantation