ABSTRACT
A 61-year-old woman was admitted with abdominal and low back pain. The patient underwent graft replacement for inflammatory abdominal aortic aneurysm. One month postoperatively, the patient fell into hypovolemic shock with massive melena and hematemesis. Laparotomy and duodenotomy revealed a fistula between the third portion of the duodenum and the distal anastomosis of the vascular prosthesis. The fistula of the aorta was repaired with omentopexy, gastrojejunostomy and Braun's anastomosis. One month later, aortoduodenal fistula recurred. The vascular prosthesis was partially removed and the aorta was closed at the infrarenal level. After the closure of the posterior duodenal defect, a left axillo-femoral bypass was constructed. She fully recovered and discharged.
ABSTRACT
A 49-year-old man who had no history of cardiac disease or intravenous drug abuse was referred to our hospital complaining of fever despite antibiotic chemotherapy. Blood culture was positive for <i>Streptococcus agalactiae</i>, and transesophageal echocardiography revealed vegetation attached to the tricuspid valve and moderate tricuspid regurgitation. Two-thirds of the anterior leaflet and a part of the posterior leaflet of the tricuspid valve were excised with the vegetation, and the remaining anterior leaflet was sutured to the posterior leaflet after annular plication. DeVega's annuloplasty was added to a diameter of two fingers. Following this procedure tricuspid regurgitation was minimal.