1/395. Repair of a pseudoaneurysm of the ascending aorta after aortic valve replacement.An elderly woman underwent an aortic valve replacement and 5 months later developed a pseudoaneurysm from the anterior aspect of the proximal ascending aorta (AA). The pseudoaneurysm was approached through a redo-median sternotomy, on cardiopulmonary bypass (CPB), mild hypothermia, and a beating heart, with a temporary fingertip occlusion of its ostium, and repaired successfully using mattress monofilament sutures enforced by pledgets. The standard approach to such pseudoaneurysms is a CPB and hypothermic circulatory arrest (HCA) prior to mid-sternotomy, and replacement of the AA. But, when a pseudoaneurysm arises from a narrow ostium on the anterior aspect of the AA, as in this case, it can be sutured closed with pledgets under CPB with a mild hypothermia and a beating heart.- - - - - - - - - - ranking = 1keywords = pseudoaneurysm (Clic here for more details about this article) |
2/395. Embolic bacterial aneurysm of the basilar artery: case report.A patient with basilar artery rupture caused by a septic embolus originating from a mitral valve vegetation is reported. The pathogenesis, investigation and management of infected cerebral aneurysms are reviewed.- - - - - - - - - - ranking = 0.10084116101222keywords = artery (Clic here for more details about this article) |
3/395. Mycotic aneurysms of the tibioperoneal arteries.This case report describes a pediatric patient with mycotic aneurysms of both posterior tibial arteries and the right peroneal artery associated with an episode of endocarditis. To our knowledge, this case represents the first reported occurrence of multiple mycotic aneurysms of the tibioperoneal arteries. It is also unique in that the pathogen was brucella canis instead of the usual gram-positive pathogens associated with intravenous drug injection. Vascular reconstruction can be accomplished; however, management of this complex problem should be individualized.- - - - - - - - - - ranking = 0.020168232202444keywords = artery (Clic here for more details about this article) |
4/395. "True" mycotic aneurysm of a renal artery allograft.A 60-year-old white man sustained a rupture of the renal artery 6 weeks after a cadaveric kidney transplantation. The bleeding site was repaired, and culture of the hematoma showed an isolated growth of candida albicans. blood and urine cultures were negative. Systemic antifungal therapy was initiated. Bleeding from the renal artery recurred, eventually requiring removal of the transplanted kidney. Histopathology of the resected specimen showed budding yeast in the wall of the renal artery, but no evidence of fungal invasion of the kidney. The patient received 6 weeks of amphotericin b therapy and currently remains on hemodialysis therapy.- - - - - - - - - - ranking = 0.14117762541711keywords = artery (Clic here for more details about this article) |
5/395. Mycotic aneurysm complicating staphylococcal endocarditis.OBJECTIVE: To emphasize the role of noninvasive diagnostic investigative methods and their importance in early detection of mycotic aneurysm related to staphylococcal endocarditis, and of monitoring therapy or identifying complications. patients AND methods: Two patients with mycotic aneurysm that developed as complications of staphylococcal endocarditis are presented. The first patient had mesenteric artery mycotic aneurysm and presented with sudden rupture one month after initial diagnosis of mitral valve infective endocarditis and completion of a full course of antimicrobial therapy. The second patient had multiple cerebral mycotic microaneurysms and presented with hemorrhagic cerebral embolization from aortic valve infective endocarditis. RESULTS: The first patient died because of ischemic cerebral edema 48 h after rupture of the mesenteric artery mycotic aneurysm and massive hemoperitoneum, which was treated surgically with distal ileal resection and ileostomy. The second patient was alive two years after prolonged antimicrobial therapy and aortic replacement to treat moderate aortic regurgitation and progressive left ventricular enlargement. CONCLUSIONS: Mycotic aneurysm is a rare complication of infective endocarditis but has a high mortality rate because of its early or late potential catastrophic rupture. diagnosis by noninvasive diagnostic imaging techniques of mycotic aneurysm before rupture would be beneficial for its treatment.- - - - - - - - - - ranking = 0.040336464404888keywords = artery (Clic here for more details about this article) |
6/395. Endovascular treatment of ruptured, peripheral cerebral aneurysms: parent artery occlusion with short Guglielmi detachable coils.We report two cases of distal cerebral aneurysms that were treated by parent artery occlusion with short Guglielmi detachable coils (GDCs). One patient had a presumed mycotic aneurysm of the distal left posterior cerebral artery, and the other had a partially clipped aneurysm of the distal right anterior inferior cerebellar artery that had hemorrhaged. Short GDCs allow controlled, accurate occlusion of the parent artery at the aneurysmal neck.- - - - - - - - - - ranking = 0.16134585761955keywords = artery (Clic here for more details about this article) |
7/395. Ruptured mycotic pulmonary artery aneurysm: an unusual complication of right-sided endocarditis.Mycotic pulmonary aneurysm is an infrequently diagnosed complication of endocarditis. We report here a case of mycotic pulmonary aneurysm and a review of 25 cases from the literature. The mortality rate is greater than 50%. Prompt diagnosis is necessary because early intrasaccular embolization and/or surgical repair is essential to avoid death from rupture of the aneurysm.- - - - - - - - - - ranking = 0.080672928809777keywords = artery (Clic here for more details about this article) |
8/395. Successful treatment of a ruptured mycotic coronary artery aneurysm.Documented mycotic aneurysms of the coronary arteries are unusual, and antemortem identification of such an aneurysm is rare. We present the case of a patient who had successful management of a ruptured mycotic aneurysm of a coronary artery.- - - - - - - - - - ranking = 0.10084116101222keywords = artery (Clic here for more details about this article) |
9/395. The spectrum of aortic complications after heart transplantation.BACKGROUND: The connection between the donor and the recipient aorta is a potential source of early and late complications as a result of infection, compliance mismatch, and technical and hemodynamic factors. Moreover, the abrupt change in systolic pressure after heart transplantation involves the entire thoracic aorta in the risk of aneurysm formation. The aim of this study was to analyze the types of aortic complications encountered in our heart transplantation series and to discuss etiology, diagnostic approach, and modes of treatment. methods: Of the 442 patients having orthotopic heart transplantation and the 11 patients having heterotopic heart transplantation at our center, 9 (2%) sustained complications involving the thoracic aorta. These 9 patients were divided into four groups according to the aortic disease: acute aortic rupture (2 patients); infective pseudoaneurysm (3 patients); true aneurysm and dissection of native aorta (2 patients); and aortic dissection after heterotopic heart transplantation (2 patients). Surgical intervention was undertaken in 8. RESULTS: Five (83%) of 6 patients who underwent surgical treatment for noninfective complications survived the operation, and 4 are long-term survivors. One patient who underwent a Bentall procedure 71/2 years after heterotopic heart transplantation died in the perioperative period of low-output syndrome secondary to underestimated chronic rejection of the graft. One patient with pseudoaneurysm survives without surgical treatment but died several years later of cardiac arrest due to chronic rejection. Both patients operated on for evolving infective pseudoaneurysm died in the perioperative period. CONCLUSIONS: Infective pseudoaneurysms of the aortic anastomosis are associated with a significant mortality. In noninfective complications, an aggressive surgical approach offers good long-term results. The possibility of retransplantation in spite of complex surgical repair should be considered in the late follow-up after heart transplantation, due to the increasing incidence of chronic rejection.- - - - - - - - - - ranking = 0.5keywords = pseudoaneurysm (Clic here for more details about this article) |
10/395. Fungal intracranial aneurysm in a child with familial chronic mucocutaneous candidiasis.We report on a patient who presented at 5 years of age with a hemiparesis due to a middle cerebral artery infarction. An embolism had originated from a mycotic aneurysm located in the internal carotid artery. For several months prior to admission he had been suffering from therapeutically resistant candidiasis of the mouth and nails. family history revealed chronic mycotic infections of the skin, hair, nails and mouth in the father and paternal grandmother suggestive of chronic mucocutaneous candidiasis with autosomal dominant mode of inheritance. Clipping of the aneurysm, after 3 months of anti-mycotic treatment, followed by sustained treatment with itraconazole and fluconazole, led to a favourable outcome. CONCLUSION: Chronic mucocutaneous candidiasis can be associated with an intracranial aneurysm and complicated by cerebral infarction.- - - - - - - - - - ranking = 0.15242263744076keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
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