Total Aortic Arch Replacement with Open Stent-Grafting of Descending Thoracic Aorta for Chronic Type A Dissecting Aneurysm after Replacement of the Ascending Thoracic Aorta-A Case Report- / 日本心臓血管外科学会雑誌

A 74-year-old woman underwent ascending aortic replacement due to acute type A dissection 2 years previously. She received total aortic arch replacement with open stent grafting of the descending thoracic aorta for enlargement of the residual aortic dissection in the aortic arch and descending thoracic aorta. Operative method and, intra- and post-operative protective method of spinal cord are reported and discussed.

Cryopreserved Aortic Homografts for the Treatment of Prosthetic Graft Infections Caused by MRSA-A Case Report- / 日本心臓血管外科学会雑誌

A 70-year-old man had undergone prosthetic graft replacement for aneurysm of the descending aorta. Postoperatively he suffered methicillin-resistant <i>Staphylococcus aureus</i> infection. Infection was controlled by antibiotics, and he was followed up in the outpatient clinic. However, he was readmitted due to high fever on the 192nd postoperative day. CT scan revealed abscess formation around the prosthetic graft. The wound was re-explored, and drainage, irrigation and packing with sponges soaked with povidoneiodine solution was performed for 3 days. After that, the prosthetic graft was replaced with a cryopreserved aortic homograft. The postoperative course was uneventful, and he showed no signs of recurrent infection for over 14 months.