Successful surgical repair of an infectious thoracic aortic pseudoaneurysm accompanied by aortobronchopulmonary fistula and advanced hepatic dysfunction without assisted circulation.
The patient was a 59-year-old female. Because of massive hemoptysis, she was brought to our emergency center by ambulance. Thoracic computed tomography led to a diagnosis of an infectious thoracic aortic pseudoaneurysm accompanied by an aortobronchopulmonary fistula. Emergency surgery followed. Also noted was an advanced hepatic dysfunction, assessed as Child-Pugh score B, caused by an alcoholic liver disease. A localized affected area made it possible for us to perform an aneurysmectomy using a temporary bypass rather than assisted circulation. A patch plasty using expanded polytetrafluoroethylene completed the procedure. Streptococcus agalactiae (GBS) was detected in a sample obtained during the surgery from an abscess located in the aneurysm. The patient made satisfactory postoperative progress and left the hospital walking unaided on the 36th postoperative day.
Masuhara
Hiroshi
H
Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan.
Watanabe
Yoshinori
Y
Fujii
Takeshiro
T
Shiono
Noritsugu
N
Hamada
Satoshi
S
Hara
Masanori
M
Teramoto
Chikao
C
Yoshihara
Katsunori
K
Koyama
Nobuya
N
D017541:Aneurysm, False / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000785:Aneurysm, Infected / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000382:microbiology*; D001027:Aortography / Q000379:methods; D019917:Blood Vessel Prosthesis Implantation; D001983:Bronchial Fistula / Q000000981:diagnostic imaging / Q000382:microbiology*; D005260:Female; D006469:Hemoptysis / Q000209:etiology; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications* / Q000503:physiopathology; D008875:Middle Aged; D012720:Severity of Illness Index; D013292:Streptococcus agalactiae / Q000302:isolation & purification; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D016157:Vascular Fistula / Q000000981:diagnostic imaging / Q000382:microbiology*
D000900:Anti-Bacterial Agents