Perigraft hemorrhage after abdominal aortic aneurysm repair in a heart transplant patient.
Spontaneous perigraft hemorrhage can occur years after a successful aortic aneurysm repair. Such hemorrhage can result, in part, from inadequate graft healing. Herein, we describe the case of a heart transplant recipient who underwent an abdominal aortic aneurysm repair that was complicated by an acute perigraft leak 6 weeks later. Apparently, suppression of the patient's immune system impaired proper healing of the graft-aortic anastomosis site. In patients who have a compromised immune system, an additional 4-0 polypropylene pledgeted suture line should be placed for reinforcement during abdominal aortic aneurysm repair. Postoperatively, patients who are given immunosuppressive therapy should undergo careful, long-term monitoring.
Department of Cardiothoracic Surgery, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Mehmet H
MH
Akay
Christoph S
CS
Nabzdyk
Igor D
ID
Gregoric
O H
OH
Frazier
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000276:immunology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D011093:Polyethylene Terephthalates; D019106:Postoperative Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000276:immunology / Q000601:surgery; D011474:Prosthesis Design; D012086:Reoperation; D013536:Suture Techniques; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
D007166:Immunosuppressive Agents; D011093:Polyethylene Terephthalates