1/48. Video-assisted crossover iliofemoral obturator bypass grafting: a minimally invasive approach to extra-anatomic lower limb revascularization.Graft infection continues to be one of the most feared complications in vascular surgery. It can lead to disruption of anastomoses with life-threatening bleeding, thrombosis of the bypass graft, and systemic septic manifestations. One method to ensure adequate limb perfusion after removal of an infected aortofemoral graft is extra-anatomical bypass grafting. We used a minimally invasive, video-assisted approach to implant a crossover iliofemoral obturator bypass graft in a patient with infection of the left limb of an aortofemoral bifurcated graft. This appears to be the first case report describing the use of this technique.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
2/48. Gas-forming clostridial mycotic aneurysm of the abdominal aorta. A case report.Gas-forming mycotic aneurysms are extremely rare. A case is reported in which rupture of a gas-forming mycotic aneurysm of the distal abdominal aorta due to Clostridium paraputrificum occurred in an elderly male with a myeloproliferative disorder and a necrotic carcinoma of the colon.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
3/48. Mycotic aneurysm of the ascending aorta following CABG.Mycotic aneurysm of the thoracic aorta is a rare and life threatening condition. Two patients are presented (both male, aged 66 and 59 years) in whom coronary artery bypass surgery was complicated by the development of a mycotic aneurysm. fever preceded the radiological and echocardiographic signs of the aneurysm by at least several months in both cases. blood cultures were negative for one patient and the source of corynebacterium sp infection in the other was not determined for several months. Both patients died before surgery could correct the aneurysm.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
4/48. Purulent pericarditis due to group B streptococcus and mycotic aneurysm of the ascending aorta: case report.A 61-year-old female, with a history of uterine and cervical cancer treated with radical hysterectomy and 2 years of postoperative chemotherapy, presented to the emergency department with dyspnea on exertion. Computed tomography of the chest revealed a large pericardial effusion and a sacciform aneurysm of the ascending aorta. The patient subsequently underwent emergency pericardiocentesis with drainage of approximately 330 ml of a bloody and turbid effusion. Cultures from the effusion yielded group B streptococcus. multiple organ failure and disseminated intravascular coagulation syndrome occurred in the acute phase, but gradually improved with continuous antibiotic therapy. On the 194th hospital day, in situ reconstruction of the ascending aorta was successfully performed using a synthetic graft. Although rarely reported, both purulent bacterial pericarditis and mycotic aneurysm can be life-threatening.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
5/48. Multiple mycotic arch-thoraco-abdominal aortic aneurysms: a successful case of in situ graft replacement.Mycotic aortic aneurysms are an uncommon yet still life-threatening pathology. We report on a 67-year-old male who had a persistent fever and back pain. Contrast enhanced computed tomography (CT) showed multiple aortic aneurysms located in the aortic arch, the descending thoracic aorta and the supraceliac abdominal aorta. After 2 months of antibiotic therapy, a staged operation was carried out with 2-week interval, which includes a graft replacement of aortic arch with elephant trunk technique and a graft replacement of thoraco-abdominal aorta with omental transfer. The postoperative course was uneventful. This case seems to be quite rare in terms of multiplicity and location of mycotic aneurysms. Surgical strategy for this pathology is discussed.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
6/48. In situ prosthetic graft repair of a mycotic aneurysm of the aorta after orthotopic liver transplantation.BACKGROUND: Vascular complications after liver transplant are associated with a high incidence of graft failure and mortality. Mycotic aneurysms, although uncommon, carry the additional risk of infection and rupture. methods: We report a case of a 51-year-old woman who developed a mycotic aneurysm of the aorta secondary to construction of an infrarenal donor iliac artery graft during a retransplant. We evaluated risk factors for the aneurysm, appropriate diagnosis, and potential treatments. RESULTS: The aneurysm was repaired with an in situ prosthetic graft. The patient is alive with good liver function 31 months posttreatment. CONCLUSIONS: The use of in situ prosthetic grafts for repair of mycotic aneurysms is appropriate in certain situations and may be life-saving.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
7/48. Ruptured mycotic thoracoabdominal aortic aneurysms: a report of three cases and a systematic review.We report three cases of ruptured mycotic thoracoabdominal aortic aneurysms (TAAAS) and a review of the literature. escherichia coli and streptococcus pneumoniae (2 patients) were the responsible organisms. Surgical management consisted of wide debridement of necrotic tissue and in situ repair with a Dacron graft. Antibiotics were administered intravenously in the hospital and continued orally after discharge for at least 6 weeks, until clinical and laboratory parameters were normalized. A review of the literature showed that Gram-negative microorganisms are found in 47% of mycotic TAAAs. A trend toward increased mortality for these organisms, compared with Gram-positive microorganisms, was observed (P =.09). Lifelong antimicrobial therapy is controversial. No difference in survival or recurrence rate was found between series advocating lifelong therapy and those suggesting prolonged (6 weeks to 12 months) therapy (median follow-up period, 18 and 19 months, respectively). In situ repair with synthetic material can be successful if prompt confirmation of infection is obtained, all possibly infected tissue is resected, and antibiotic therapy based on sensitivity data is administered for a prolonged period. A short-term survival rate as high as 82% can be expected with this strategy, but data on long-term survival rates are limited. polytetrafluoroethylene-expanded grafts, homografts, and antibiotic-bonded grafts may offer advantages over Dacron grafts, but data are insufficient to draw conclusions. Careful long-term follow-up is an important element of the treatment of these patients. We suggest antibiotic treatment until biochemical parameters of inflammation (white cell count, erythrocyte sedimentation rate, or c-reactive protein) return to normal and a computerized tomography scan every 3 months for 1 year, then annually.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
8/48. Mycotic pseudoaneurysm associated with aortic coarctation.Development of a mycotic aneurysm or pseudoaneurysm after subacute bacterial endarteritis is uncommon. Nonetheless, patients with coarctation of the aorta are more likely to develop this complication. We describe a case of a large pseudoaneurysm discovered in a child with a previously undiagnosed aorta coarctation. Successful repair was performed with the aid of partial left heart bypass and the use of an interposition graft. A high index of suspicion is necessary to accurately diagnose this rare but life-threatening entity.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
9/48. Clostridial mycotic aneurysm of the thoracoabdominal aorta--a case report.Clostridial infection of the aorta is a rare and life-threatening condition. The management of a mycotic aneurysm involving the thoracoabdominal aorta due to clostridium septicum infection is presented. Successful surgical management of the aortic infection involved arterial resection, wide debridement of the surrounding tissues, and in situ graft replacement. Sixteen additional cases of clostridial infection of the aortoiliac segment reported in the literature are also summarized. In ten of these 17 cases, an associated colonic adenocarcinoma was documented.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
10/48. Mycotic aortocaval fistula: efficient evaluation by bolus-chase MR angiography.Aortocaval fistula (ACF) is a rare but life-threatening condition. This case report describes the use of bolus-chase gadolinium-enhanced 3D magnetic resonance angiography (MRA) to provide an efficient evaluation of a patient with ACF associated with a mycotic abdominal aortic aneurysm. This case highlights the ability of bolus-chase MRA to provide both the specific diagnosis of ACF as well as the information necessary for extra-anatomic arterial bypass. Bolus-chase MRA is a promising method for the evaluation of patients with this disease entity.- - - - - - - - - - ranking = 1keywords = life (Clic here for more details about this article) |
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