Stent-graft repair of a mycotic ascending aortic pseudoaneurysm.
A 75-year-old woman with a history of coronary artery bypass surgery complicated by mediastinitis presented with hemoptysis and fever. An enlarging pseudoaneurysm of the ascending aorta was found on computed tomography (CT) and magnetic resonance imaging. After a bypass graft procedure for cerebral and cardiac protection, two endoprosthetic cuffs, which are normally used for proximal abdominal aortic stent-graft extension, were positioned over the pseudoaneurysm neck via right carotid artery access. Blood cultures revealed methicillin-sensitive Staphylococcus aureus, and antibiotic therapy was continued for 6 weeks. Follow-up CT images demonstrated exclusion of the pseudoaneurysm with decrease in size over time. Endovascular stent-graft placement combined with antibiotic therapy may offer an alternative to surgery for the management of mycotic ascending aortic pseudoaneurysm.
Heye
Sam
S
Departments of Radiology, Center for Vascular Diseases, University Hospital Gasthuisberg, Herestraat 49, B-3000 Leuven, Belgium. sam.heye@uz.kuleuven.ac.be
Daenens
Kim
K
Maleux
Geert
G
Nevelsteen
Andre
A
D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001026:Coronary Artery Bypass; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000601:surgery; D006801:Humans; D018810:Magnetic Resonance Angiography; D015607:Stents; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome