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Eur J Cardiothorac Surg 2000;17:184-186
© 2000 Elsevier Science NL

Case report

Multiple mycotic arch-thoraco-abdominal aortic aneurysms: a successful case of in situ graft replacement

Department of Cardiovascular Surgery, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai 591-8025, Japan

Corresponding author. Tel.: +81-722-52-3561; fax: +81-722-55-3349
e-mail: skuki{at}orh.go.jp

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.

Key Words: Mycotic aneurysm • Thoraco-abdominal aortic aneurysm • Graft replacement • Elephant trunk • Omental transfer