title: Explantation of infected aortic aneurysm and endograft with ascending aorta to mesenteric bypass for mesenteric ischemia.
abstract: A 65-year-old man presented with an infected perivisceral aortic aneurysm after previous treatment of an abdominal aortic aneurysm with an endograft. On presentation, he was septic and had occlusion of the celiac, superior mesenteric, inferior mesenteric, and bilateral renal arteries. He underwent a three-stage procedure: first, axillobifemoral bypass; then resection of the thoracoabdominal aorta; and finally bypass from the ascending aorta to the celiac and superior mesenteric arteries with a rifampin-soaked Gelsoft graft (Vascutek, Renfrewshire, Scotland). The abdominal pain resolved, and the patient remains symptom free 10 months postoperatively. This rare surgical revascularization technique offered a nontraditional solution to a difficult surgical issue.
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Lindsay
authors.initials: L
authors.lastname: Gates
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Chin
authors.affiliation: Section of Cardiac Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Pramod N
authors.initials: PN
authors.lastname: Bonde
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Cassius I
authors.initials: CI
authors.lastname: Ochoa Chaar
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn.
authors.forename: Bauer E
authors.initials: BE
authors.lastname: Sumpio
authors.affiliation: Section of Vascular Surgery, Yale University School of Medicine, New Haven, Conn. Electronic address: timur.sarac@yale.edu.
authors.forename: Timur P
authors.initials: TP
authors.lastname: Sarac
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D017544:Aortic Aneurysm, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D002445:Celiac Artery / Q000503:physiopathology / Q000601:surgery; D020099:Coated Materials, Biocompatible; D003097:Collateral Circulation; D000072226:Computed Tomography Angiography; D020878:Device Removal / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation*; D006499:Hepatic Artery / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D017538:Mesenteric Artery, Superior / Q000503:physiopathology / Q000601:surgery; D065666:Mesenteric Ischemia / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D008641:Mesenteric Vascular Occlusion / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000000981:diagnostic imaging / Q000382:microbiology / Q000503:physiopathology / Q000601:surgery*; D012086:Reoperation; D012293:Rifampin / Q000008:administration & dosage; D013152:Splanchnic Circulation; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible; D012293:Rifampin