Aortic Sepsis with Aorto-Pulmonary Fistula Following Infective Endocarditis (IE) / 日本心臓血管外科学会雑誌
Japanese Journal of Cardiovascular Surgery
;
: 161-163, 2003.
Article
in Japanese
| WPRIM
| ID: wpr-366867
ABSTRACT
A 59-year-old man presented with sporadic febrile illness. Echocardiography showed multiple vegetations on the mitral valve. Blood culture yielded <i>Viridans streptococci</i>. Mitral valve replacement was performed, and a high dose of penicillin G sodium (24 million U/day) was administrated for 4 weeks postoperatively. On the 28th postoperative day, the patient developed severe back pain and bloody sputum. Chest CT showed a false aneurysm of the distal aortic arch (5.5cm). The patient was placed on cardiopulmonary bypass with the arterial return in the mid-aortic arch. The aneurysm was resected and replaced with a Dacron tube during deep hypothermic circulatory arrest. The aortic wall was interspersed with mobile nodules that appeared to be colonized. The aorto-pulmonary fistula was directly closed. The whole procedure was carried out through the 4th intercostal space. The tissue culture was negative but histopathology suggested a persistent inflammatory process. Excavating aortic sepsis may occur following active endocarditis. Even if cardiac infection is controlled, continuous search should be undertaken for possible dilatation in remote parts of the arterial system.
Full text:
Available
Index:
WPRIM (Western Pacific)
Language:
Japanese
Journal:
Japanese Journal of Cardiovascular Surgery
Year:
2003
Type:
Article
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