title: En bloc resection and extended replacement of the infected aortic arch.
abstract: We present the technical details of en bloc resection and extended replacement of an infected aortic arch. A 74-year-old man underwent emergent surgery under a diagnosis of impending rupture of an infected aortic arch aneurysm. The patient's chest was entered through a median sternotomy with a left thoracotomy at the fourth intercostal space. After dissection of the left phrenic and left recurrent nerves, the infected aortic arch was widely excised en bloc under circulatory arrest with selective cerebral perfusion. It was replaced with a rifampicin-bonded prosthetic graft. The prosthesis and anastomoses were covered with a harvested omental flap. Although an appropriate approach and supportive therapy are indispensable, en bloc resection of the infected tissue is an important technique when treating infected aortic aneurysms.
authors.affiliation: Department of Cardiovascular Surgery, Sakakibara Heart Institute of Okayama, 2-1-10 Marunouchi, Kita-ku, Okayama 700-0823, Japan. toshinoritotsugawa@mac.com
authors.forename: Toshinori
authors.initials: T
authors.lastname: Totsugawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takiuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kuinose
authors.forename: Hidenori
authors.initials: H
authors.lastname: Yoshitaka
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Tsushima
authors.forename: Atsuhisa
authors.initials: A
authors.lastname: Ishida
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed