ABSTRACT
Mycotic aortic aneurysm is a rare disease which is caused by bacterial infection of the aortic wall, grows rapidly with subsequent rupture and has high mortality. We report a case of successful anatomical reconstruction for mycotic abdominal aortic aneurysm with infectious abcess. A 59-year-old man who was found to have an impending rupture of abdominal aortic aneurysm underwent emergency anatomical reconstruction. At operation, an active infectious abcess was noted around the abdominal aorta. Successful management of this disease depends on early accurate preoperative diagnosis, complete resection and debridment of infected tissues, anatomical graft replacement and adjuvant antibiotic chemotherapy.
ABSTRACT
We describe successful surgical treatment of blow-out type left ventricular free wall rupture (LVFWR) that suddenly occurred in a 66-year-old man 6 days after antero-lateral acute myocardial infarction. Immediate use of a percutaneous cardiopulmonary support system (PCPS) and intra-aortic balloon pumping (IABP) successfully resuscitated the patient, followed by emergency operation for the beating heart under PCPS and IABP. The actively bleeding site, located at the antero-lateral wall, was gently approximated by large bites of mattress suture with pledgets to close the rupture site, and the site was then additionally covered with oxycel and fibrin glue. The infarct area was finally widely covered with a large patch of equine pericardium. This simple surgical method for the beating heart under PCPS and IABP can provide a prompt and less invasive surgical cure for critically ill patients with blow-out type LVFWR.