Usefulness of bridging thoracic endovascular aortic repair and sac irrigation followed by open repair in patients with mycotic thoracic aortic aneurysms

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Presentation transcript:

Usefulness of bridging thoracic endovascular aortic repair and sac irrigation followed by open repair in patients with mycotic thoracic aortic aneurysms Hideki Oshima, MD, PhD, Kiyohito Yamamoto, MD, PhD, Kimihiro Komori, MD, PhD, Akihiko Usui, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 5, Pages 2422-2424 (November 2014) DOI: 10.1016/j.jtcvs.2014.06.088 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 A, Computed tomographic scans showed a mycotic aneurysm of the aortic arch (arrow) before thoracic endovascular aortic repair (upper row, axial image; lower row, 3-dimensional reconstruction). B, Computed tomographic scans obtained after thoracic endovascular aortic repair showed complete shielding of the aneurysm (upper row, axial image, lower row, 3-dimensional reconstruction). C, Intraoperative findings. The mycotic aneurysm in the aortic arch was completely shielded by the stent graft (arrow). D, A computed tomographic scan obtained after open surgery showed in situ reconstruction of the distal aortic arch and left subclavian artery. Asc. Ao, Ascending aorta. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2422-2424DOI: (10.1016/j.jtcvs.2014.06.088) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 A, A computed tomographic scan with curved multiplanar reconstruction obtained before thoracic endovascular aortic repair showed a large mycotic aneurysm in the aortic arch. B, A computed tomographic scan obtained after thoracic endovascular aortic repair showed no leakage into the aneurysmal cavity. C, Four days after thoracic endovascular aortic repair, percutaneous drainage of the aneurysmal cavity was performed under computed tomographic guidance. D and E, Intraoperative findings. D, The mycotic aneurysm in the aortic arch (arrowhead). E, The aneurysm was completely shielded by the stent graft (arrow). The purple-colored tissue (arrowhead) indicates gentian violet staining. BCA, Brachiocephalic artery; Asc. Ao, ascending aorta. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 2422-2424DOI: (10.1016/j.jtcvs.2014.06.088) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions