En bloc resection and extended replacement of the infected aortic arch

We present the technical details of en bloc resection and extended replacement of an infected aortic arch. A 74-year-old man underwent emergent surgery under a diagnosis of impending rupture of an infected aortic arch aneurysm. The patient’s chest was entered through a median sternotomy with a left...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2011-06, Vol.59 (6), p.418-421
Main Authors: Totsugawa, Toshinori, Takiuchi, Hiroki, Kuinose, Masahiko, Yoshitaka, Hidenori, Tsushima, Yoshimasa, Ishida, Atsuhisa
Format: Article
Language:English
Subjects:
Aged
Aneurysm, Infected - diagnosis
Aneurysm, Infected - surgery
Aorta, Thoracic - surgery
Aortic Aneurysm, Thoracic - diagnosis
Aortic Aneurysm, Thoracic - surgery
Blood Vessel Prosthesis Implantation - methods
Cardiac Surgery
Cardiology
Case Report
Diagnosis, Differential
Echocardiography
Follow-Up Studies
Humans
Male
Medicine
Medicine & Public Health
Surgical Oncology
Thoracic Surgery
Thoracotomy
Tomography, X-Ray Computed
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Summary:We present the technical details of en bloc resection and extended replacement of an infected aortic arch. A 74-year-old man underwent emergent surgery under a diagnosis of impending rupture of an infected aortic arch aneurysm. The patient’s chest was entered through a median sternotomy with a left thoracotomy at the fourth intercostal space. After dissection of the left phrenic and left recurrent nerves, the infected aortic arch was widely excised en bloc under circulatory arrest with selective cerebral perfusion. It was replaced with a rifampicin-bonded prosthetic graft. The prosthesis and anastomoses were covered with a harvested omental flap. Although an appropriate approach and supportive therapy are indispensable, en bloc resection of the infected tissue is an important technique when treating infected aortic aneurysms.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-010-0697-5