Surgical management of mycotic aneurysm of the left anterior descending artery.
Mycotic aneurysms of the coronary artery with underlying infective endocarditis are rare. The present report discusses the case of a 53-year-old woman with acute ST elevation myocardial infarction in the setting of native aortic valve endocarditis. Percutaneous transluminal coronary angioplasty was performed. Approximately four weeks after hospital admission, the patient had systemic embolization to the extremities with resulting cyanosis of the left toes. She was evaluated for replacement of the aortic valve and underwent a repeat angiogram, which demonstrated a mycotic aneurysm at the site of the angioplasty. She subsequently underwent successful excision of the aneurysm with coronary artery bypass grafting and replacement of the aortic valve with a 21 mm St Jude aortic valve prosthesis. The remaining hospital course was unremarkable.
Department of Internal Medicine, Marshfield Clinic, Wisconsin, USA.
Sumeesh
S
Dhawan
Donald
D
Schreiber
Charles S
CS
McCauley
Hope S
HS
Maki
Tahir
T
Tak
D000785:Aneurysm, Infected / Q000150:complications / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D001021:Aortic Valve; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000473:pathology; D003937:Diagnosis, Differential; D016983:Enterococcus; D005260:Female; D016908:Gram-Positive Bacterial Infections / Q000150:complications*; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008875:Middle Aged