A Case of Mycotic Pseudoaneurysm of the Brachiocephalic Artery

VernacularTitle:感染性腕頭動脈仮性瘤の１例
Author: Motohiko Goda ; Kiyotaka Imoto ; Shinichi Suzuki ; Keiji Uchida ; Toshiki Hatsune ; Yoshinori Takanashi
Publication Type:Journal Article
From:Japanese Journal of Cardiovascular Surgery 2006;35(3):164-167
CountryJapan
Language:Japanese
Abstract: A 61-year-old man admitted to another hospital because of cerebral infarction had fever (about 39°C). Computed tomographic scanning revealed a pseudoaneurysm of the brachiocephalic artery, accompanied by pericardial fluid. The patient was transferred to our hospital. Culture studies of a sample of pericardial fluid revealed Staphylococcus aureus. A mycotic pseudoaneu-rysm of the brachiocephalic artery was diagnosed. Antibiotics were given for about 2 weeks after transfer to our hospital. Surgery was performed after the inflammation subsided. The pseudoaneurysm was incised during circulatory arrest. A hole measuring 2cm in diameter was found at the origin of the brachiocephalic artery. The hole was sealed with an autologous arterial patch, made from a 3-cm section of the right axillary artery. The axillary artery was reconstructed by end-to-end anastomosis. After surgery, infection was controlled by means of systemic antibiotics and closed mediastinal lavage. The patient was discharged from the hospital in good condition 160 days after surgery. To date, there has been no flare-up of infection.