Successful Surgical Repair for Rupture of Penetrating Atherosclerotic Ulcer with MRSA Infection of a Porcelain Descending Aorta
10.4326/jjcvs.38.44
- VernacularTitle:感染により下行大動脈穿孔を来たした porcelain aorta に対する治療経験
- Author:
Kimihiro Yoshimoto
;
Junichi Oba
;
Taro Minamida
;
Akira Adachi
;
Tsukasa Miyatake
;
Hidetoshi Aoki
- Publication Type:Journal Article
- Keywords:
PAU;
porcelain aorta
- From:Japanese Journal of Cardiovascular Surgery
2009;38(1):44-48
- CountryJapan
- Language:Japanese
-
Abstract:
A 41-year-old man with focal glomerulosclerosis had been treated by hemodialysis for 22 years. Kidney transplantation from a living donor was performed once, but the transplanted kidney was removed out because it had been infected by methicillin-resistant Staphylococcus aureus about 3 months previously. He was admitted to our hospital with over 38°C fever 2 months after the removal. He had hemoptysis and marked back pain. Computed tomography scan revealed ruptured descending aorta. The descending aorta was circumferentially calcified but not enlarged. We thought that a penetrating atherosclerotic ulcer had formed in a crack of the porcelain aorta and ruptured with infection. First we tried endovascular treatment with stent-graft implantation. It was useful to control hemoptysis, but a small amount of type I leakage remained. Finally, after controlling the infection, we performed prosthesis replacement with extra-corporeal circulation and surrounded the artificial aorta with the omentum. The postoperative course was uneventful and he recovered completely.
