title: Invasive Methicillin-Resistant Staphylococcus Aureus Endocarditis Resulting in Right Ventricular Pseudoaneurysm and Fistulation to Previous Bypass Graft.
abstract: We describe the case of a 73-year-old man with methicillin-resistant Staphyloccocus aureus (MRSA) endocarditis, which developed into a right ventricular pseudoaneurysm that fistulated into a previous saphenous vein graft to his distal right coronary artery (RCA). The patient was taken for a redo sternotomy, surgical evacuation of the abscess, bovine pericardial patch reconstruction of the right ventricular free wall, and tricuspid valve repair. Despite our best efforts and a repair that appeared sufficient at the time of operation, the patient died of ischemic colitis on postoperative day 5. This case report highlights some of the surgical considerations for such a rare and lethal condition.
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Matthew
authors.initials: M
authors.lastname: Valdis
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada.
authors.forename: Jill
authors.initials: J
authors.lastname: Gelinas
authors.affiliation: Division of Cardiac Surgery, Department of Surgery, Western University, London Health Sciences Centre, London, Ontario, Canada. Electronic address: linrui.guo@lhsc.on.ca.
authors.forename: Linrui
authors.initials: L
authors.lastname: Guo
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000382:microbiology*; D001026:Coronary Artery Bypass; D004697:Endocarditis, Bacterial / Q000382:microbiology*; D006322:Heart Aneurysm / Q000382:microbiology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D011183:Postoperative Complications / Q000382:microbiology*; D013203:Staphylococcal Infections / Q000150:complications*; D016157:Vascular Fistula / Q000382:microbiology*