title: Successful management of a giant unruptured mycotic coronary artery aneurysm after coronary angioplasty.
abstract: Coronary artery stent infection has been reported with both bare metal stent and drug eluting stent and can present as mycotic coronary artery aneurysm, pseudoaneurysm, myocardial abscess, pericarditis or exudative effusion. Infection at the site of coronary stent implantation is rare and is believed to result typically from either direct stent contamination at the time of delivery or transient bacteraemia from access site. Introduction of drug-eluting stent (DES) has led to a marked reduction in the problem of in-stent restenosis across all patient subsets and lesions complexities. Recently, several case reports of pseudoaneurysm formation after DES implantation have been reported in the literature. We describe the successful surgical management of giant mycotic pseudoaneurysm of left anterior descending artery (LAD) presenting as fever of unknown origin. This report illustrates the importance of early detection and prompt management of these rare coronary pseudoaneurysms, which is a highly lethal condition.
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medanta - The Medicity, Gurgaon, Haryana, India. Electronic address: draggarwal.pankaj@gmail.com.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Aggarwal
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: Pravin
authors.initials: P
authors.lastname: Saxena
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, Medanta - The Medicity, Gurgaon, Haryana, India.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhan
mesh_terms: D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000072226:Computed Tomography Angiography; D003323:Coronary Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery; D020878:Device Removal / Q000379:methods*; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000382:microbiology; D017548:Echocardiography, Transesophageal; D006801:Humans; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011549:Pseudomonas / Q000302:isolation & purification; D011552:Pseudomonas Infections / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D012720:Severity of Illness Index
keywords: Mycotic coronary artery aneurysm