title: Successful surgical repair of an infectious thoracic aortic pseudoaneurysm accompanied by aortobronchopulmonary fistula and advanced hepatic dysfunction without assisted circulation.
abstract: 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.
authors.affiliation: Division of Cardiovascular Surgery, Department of Surgery, School of Medicine, Faculty of Medicine, Toho University, 6-11-1 Omorinishi, Ota-ku, Tokyo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Masuhara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Takeshiro
authors.initials: T
authors.lastname: Fujii
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Shiono
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hamada
authors.forename: Masanori
authors.initials: M
authors.lastname: Hara
authors.forename: Chikao
authors.initials: C
authors.lastname: Teramoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yoshihara
authors.forename: Nobuya
authors.initials: N
authors.lastname: Koyama
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents