In situ replacement of the thoracic aorta using an equine pericardial roll graft for an aortobronchial fistula due to aortic rupture.
A 74-year-old woman with massive hemoptysis and shock who had been diagnosed with thoracic aortic rupture underwent in situ replacement of the thoracic aorta using an equine pericardial roll graft. The lower lobe of the left lung was resected because of a massive hematoma and adhesion to the wall of the thoracic aorta. Intraoperative microscopic examination of the resected aortic wall revealed Gram-positive bacteria (alpha-streptococcus in bacterial cultivation). Histology of the resected aorta revealed abscess formation in the media and adventitia of the aortic wall associated with disruption of the media (dissection). Postoperative computed tomography revealed no fluid collection around the graft 1 month after surgery, and magnetic resonance imaging showed no significant graft dilation 20 months after operation. The equine pericardium can be an option of alternative graft materials for in situ replacement of the thoracic aorta in patients with an aortobronchial fistula due to aortic rupture.
Yamamoto
Hiroshi
H
Department of Cardiovascular Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan.
Yamamoto
Fumio
F
Ishibashi
Kazuyuki
K
Chida
Yoshifumi
Y
Minamiya
Yoshihiro
Y
Nanjo
Hiroshi
H
D000368:Aged; D000818:Animals; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001019:Aortic Rupture / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001705:Bioprosthesis; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology / Q000601:surgery*; D003646:Debridement; D005260:Female; D006469:Hemoptysis / Q000209:etiology / Q000601:surgery; D006736:Horses; D006801:Humans; D018810:Magnetic Resonance Angiography; D010496:Pericardium / Q000637:transplantation*; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000601:surgery; D013291:Streptococcus / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000209:etiology / Q000382:microbiology / Q000601:surgery*