title: [Mycotic Aneurysm of Distal Aortic Arch, after Total Arch Replacement with Open-stent Graft;Report of a Case].
abstract: The patient was a 72-year-old man, who had undergone total arch replacement with an open-stent graft due to saccular aneurysm of distal arch, 2 years before. He was admitted to a local hospital with the complaint of high fever, and was diagnosed as having pyothorax, after computed tomography (CT) scanning. After transferred to our hospital, he was treated by drainage, and antibiotic therapy. But CT scans showed the enlargement of distal arch aneurysm, and migration of the stent graft. Urgent operation was performed. We approached to the site by a full sternotomy, and left anterolateral thoracotomy. Segment 1+2 of the left lung was resected to avoid bleeding and lung injury. Graft replacement of distal arch and descending aorta was performed on cardiopulmonary bypass, with hypothermia, selective brain perfusion and systemic circulatory arrest. To protect from recurrence of infection, the omental flap was transposed to the graft site. Until now, there is no recurrence of infection.
authors.affiliation: Department of Cardiovascular Surgery, Yamagata Prefectural Central Hospital, Yamagata, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Suzuki
authors.forename: Yu
authors.initials: Y
authors.lastname: Kawahara
authors.forename: Naoki
authors.initials: N
authors.lastname: Masaki
authors.forename: Yuriko
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Shingo
authors.initials: S
authors.lastname: Takahara
authors.forename: Ken
authors.initials: K
authors.lastname: Nakamura
authors.forename: Shuji
authors.initials: S
authors.lastname: Toyama
authors.forename: Manabu
authors.initials: M
authors.lastname: Fukasawa
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D002315:Cardiopulmonary Bypass; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D015607:Stents; D056346:Sternotomy; D013908:Thoracotomy; D014057:Tomography, X-Ray Computed; D014657:Vasculitis / Q000150:complications