Alternative surgical strategy for the treatment of a mycotic aortic arch aneurysm.
We report the case of a 69-year-old man who presented with a symptomatic mycotic aneurysm of the aortic arch. Diagnosis was confirmed by positron emission tomography and by blood cultures positive for Salmonella species. A complete resection of the aortic arch process was performed via left thoracotomy using a cryopreserved aortic homograft and normothermic left heart bypass. The left-sided cerebral vessels were clamped, and adequacy of collateral left brain flow and oxygenation was confirmed by neurophysiologic monitoring. Using this less-invasive operative strategy, we avoided the risks inherent to deep hypothermic circulatory arrest and the use of prosthetic materials.
Pagni
Sebastian
S
Division of Thoracic and Cardiovascular Surgery, Department of Surgery, University of Louisville, Louisville, Kentucky 40202, USA. jwalsh@ucsamd.com
Ganzel
Brian L
BL
Edmonds
Harvey L
HL
D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D015925:Cryopreservation; D006801:Humans; D008297:Male; D049268:Positron-Emission Tomography; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed