title: Septic rupture of the ascending aorta after aortocoronary bypass surgery.
abstract: We describe an exceptional case of non-fatal septic rupture of the ascending aorta in a patient with sternal dehiscence, deep sternal wound infection (DSWI) and pleural empyema after aortocoronary bypass surgery. Routine follow-up computed tomography (CT) detected a mediastinal pseudoaneurysm originating from the ascending aorta. Thereby, massive and irregular sternal bone defects and contrast-enhancing mediastinal soft tissue suggest osteomyelitis and highly-active and aggressive DSWI as initial triggers. Urgent thoracotomy 1 day later included ascending aorta reconstruction, total sternum resection and broad wound debridement. Follow-up CT 1 year later showed a regular postoperative result in a fully recovered patient.
authors.affiliation: Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany. christof.sommer@med.uni-heidelberg.de
authors.forename: Christof M
authors.initials: CM
authors.lastname: Sommer
authors.forename: Tobias
authors.initials: T
authors.lastname: Heye
authors.forename: Ulrike
authors.initials: U
authors.lastname: Stampfl
authors.forename: Ursula
authors.initials: U
authors.lastname: Tochtermann
authors.forename: Boris A
authors.initials: BA
authors.lastname: Radeleff
authors.forename: Hans U
authors.initials: HU
authors.lastname: Kauczor
authors.forename: Goetz M
authors.initials: GM
authors.lastname: Richter
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000209:etiology / Q000601:surgery*; D001011:Aorta / Q000601:surgery; D001019:Aortic Rupture / Q000209:etiology / Q000601:surgery*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006801:Humans; D008297:Male; D011859:Radiography; D013249:Sternum / Q000000981:diagnostic imaging / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000209:etiology / Q000601:surgery; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome