title: Multiple organ embolization with vegetation on an elephant trunk graft.
abstract: We encountered a rare case of infection in a vascular graft created using the elephant trunk technique. A 65-year-old woman who underwent total arch replacement with the elephant trunk technique was re-admitted with fever. She developed embolization of multiple organs from vegetation attached to the elephant trunk graft which was elucidated by transesophageal echocardiography. Surgery for ruptured jejunal artery aneurysm was performed, and the graft infection healed after long-term antibiotic therapy with the prosthesis left in situ. Graft infection may generate vegetations on an elephant trunk graft. Transesophageal echocardiography is a helpful tool for accurate diagnosis.
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan. jm-tashiro-m@kochi-u.ac.jp.
authors.forename: Miwa
authors.initials: M
authors.lastname: Tashiro
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Nishimori
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fukutomi
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Takemi
authors.initials: T
authors.lastname: Handa
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kondo
authors.affiliation: Department of Cardiovascular Surgery, Kochi University, Kohasu Oko-cho Nankoku-shi, Kochi, 783-8505, Japan.
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Orihashi
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000601:surgery; D001013:Aorta, Thoracic / Q000601:surgery; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D017548:Echocardiography, Transesophageal / Q000379:methods; D004617:Embolism / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed
keywords: Elephant trunk; Embolization; Vegetation