title: Graft placement with an omental flap for ruptured infective common iliac aneurysm in a patient with a continuous flow left ventricular assist device: alternative surgical approach avoiding driveline injury and pathogen identification by 16S ribosomal DNA gene analysis.
abstract: Patients supported by mechanical circulatory support have to wait for longer periods for heart transplantation in Japan. Infective events are a major complication and influence survival. Here, we present the case of a patient with an implantable left ventricular assist device for 6 months who had the complication of ruptured infective common iliac aneurysm. Graft placement with an omental flap was successfully performed via the alternative surgical approach to avoid percutaneous driveline injury. In samples of aortic specimens, 16S ribosomal DNA gene analysis identified Helicobacter cinaedi. Complete removal of the infected tissue and correct pathogen identification may have been relevant to the good clinical course.
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan. akiyamam@med.tohoku.ac.jp.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Akiyama
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hayatsu
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Sakatsume
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Daijirou
authors.initials: D
authors.lastname: Akamatsu
authors.affiliation: Division of Infection Control and Laboratory Diagnosis, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Risako
authors.initials: R
authors.lastname: Kakuta
authors.affiliation: Division of Infection Control and Laboratory Diagnosis, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Division of Infection Control and Laboratory Diagnosis, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Kaku
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Kumagai
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kawamoto
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Goto
authors.affiliation: Division of Advanced Surgical Science and Technology, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
authors.affiliation: Division of Cardiovascular Surgery, Tohoku University Graduate School of Medicine, 1-1Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan.
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Saiki
mesh_terms: D017542:Aneurysm, Ruptured / Q000382:microbiology / Q000601:surgery*; D004275:DNA, Ribosomal / Q000737:chemistry; D006353:Heart-Assist Devices / Q000009:adverse effects*; D016998:Helicobacter / Q000235:genetics / Q000302:isolation & purification*; D016481:Helicobacter Infections / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D017543:Iliac Aneurysm / Q000382:microbiology / Q000601:surgery*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000637:transplantation; D012336:RNA, Ribosomal, 16S / Q000235:genetics*; D013524:Surgical Flaps; D058017:Vascular Grafting / Q000379:methods*
chemical_list: D004275:DNA, Ribosomal; D012336:RNA, Ribosomal, 16S
keywords: 16S ribosomal DNA gene analysis; Infection; Mycotic aneurysm; Ventricular assist device