1/226. 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, aneurysm (Clic here for more details about this article) |
2/226. Pseudoaneurysm of the left ventricle after isolated pericarditis and staphylococcus aureus septicemia.Left ventricular pseudoaneurysm after isolated pericarditis as a result of Staphylococcal septicemia is very rare. A case of a very young patient is described. diagnosis is made by echocardiography. Immediate surgical resection of the pseudoaneurysm is the therapy of choice.- - - - - - - - - - ranking = 0.36804288347069keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
3/226. 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 = 0.32461792954439keywords = aneurysm (Clic here for more details about this article) |
4/226. Recurrent endocarditis in silver-coated heart valve prosthesis.BACKGROUND AND AIM OF THE STUDY: In order to prevent prosthetic valve endocarditis (PVE), the implantation of a new silver-coated sewing ring has been introduced to provide peri- and postoperative protection against microbial infection. methods: A 56-year-old woman with aortic stenosis had elective replacement with a St. Jude Medical mechanical valve fitted with a silver-coated sewing ring (Silzone). The patient developed early PVE, which necessitated reoperation after one month. Despite a second Silzone prosthesis being implanted, the endocarditis recurred. During a third operation an aortic homograft was implanted, and after six months a fourth operation was performed for a pseudoaneurysm at the base of the homograft, in proximity to the anterior mitral valve leaflet. RESULTS: The diagnosis of PVE was confirmed by the presence of continuous fever, transesophageal echocardiography and growth of penicillin-resistant staphylococcus epidermidis from the valve prosthesis. CONCLUSION: The implantation of all prosthetic valves is encumbered with a risk of endocarditis. Although silver has bacteriostatic actions, the advantages of silver-coated prostheses in the treatment of this condition have yet to be assessed in clinical trials.- - - - - - - - - - ranking = 0.125keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
5/226. 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 = 0.2065750460737keywords = aneurysm (Clic here for more details about this article) |
6/226. Left ventricular pseudoaneurysm complicating infective pericarditis.Cross sectional echocardiography demonstrated a pseudoaneurysm of the left ventricular posterolateral wall close to the atrioventricular junction in a 4 year old girl with infective pericarditis complicating lobar pneumonia. Colour flow Doppler demonstrated bidirectional flow across the communication hole. Surgical resection was successful.- - - - - - - - - - ranking = 0.625keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
7/226. Endovascular occlusion of a carotid pseudoaneurysm complicating deep neck space infection in a child. Case report.Pseudoaneurysm formation of the cervical internal carotid artery (ICA) is a rare, potentially lethal complication of deep neck space infection. This entity typically occurs following otolaryngological or upper respiratory tract infection. The pseudoaneurysm is heralded by a pulsatile neck mass, Homer's syndrome, lower cranial neuropathies, and/or hemorrhage that may be massive. The recommended treatment includes prompt arterial ligation. The authors present a case of pseudoaneurysm of the cervical ICA complicating a deep neck space infection. A parapharyngeal staphylococcus aureus abscess developed in a previously healthy 6-year-old girl after she experienced pharyngitis. The abscess was drained via an intraoral approach. On postoperative Day 3, the patient developed a pulsatile neck mass, lethargy, ipsilateral Horner's syndrome, and hemoptysis, which resulted in hemorrhagic shock. Treatment included emergency endovascular occlusion of the cervical ICA and postembolization antibiotic treatment for 6 weeks. The patient has made an uneventful recovery as of her 18-month follow-up evaluation. Conclusions drawn.from this experience and a review of the literature include the following: 1) mycotic pseudoaneurysms of the carotid arteries have a typical clinical presentation that should enable timely recognition; 2) these lesions occur more commonly in children than in adults; 3) angiography with a view to performing endovascular occlusion should be undertaken promptly; and 4) endovascular occlusion of the pseudoaneurysm is a viable treatment option.- - - - - - - - - - ranking = 1.0295107208677keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
8/226. Subclavian arteritis and pseudoaneurysm formation secondary to stent infection.Technically uncomplicated percutaneous angioplasty and stent placement of a left subclavian artery stenosis was performed in a 56-year-old man for treatment of subclavian steal syndrome and vertebrobasilar insufficiency. Six days later the patient was readmitted with staphylococcus aureus bacteremia and stigmata of septic emboli isolated to the ipsilateral hand. Nine days later he had computed tomography (CT) evidence of a contrast-enhancing phlegmon surrounding the stent. Despite clinical improvement and resolution of bacteremia on intravenous antibiotic therapy, the phlegmon progressed, and at day 21 a pseudoaneurysm was angiographically confirmed. The patient underwent surgical removal of the stented arterial segment and successful autogenous arterial reconstruction. The possible contributory factors leading to stent infection were prolonged right femoral artery access and an infected left arm venous access. Although the role of prophylactic antibiotics remains to be defined, it may be important in cases where the vascular access sheath remains in place for a prolonged period of time.- - - - - - - - - - ranking = 0.625keywords = pseudoaneurysm, aneurysm (Clic here for more details about this article) |
9/226. cardiac tamponade: an unusual, fatal complication of infective endocarditis.Infective endocarditis still occurs in Western countries and so far, it has been an important medical problem. The spectrum of infective endocarditis complications may be extremely wide. We report two unusual cases of infective endocarditis complicated with heart rupture and pericardial effusion. In one case, the infective process spread from the aortic valve developing a sinus of valsalva aneurysm with subsequent aortic perforation. The perforation reached the right auricular epicardial region with subsequent epicardial rupture and hemopericardium. In the other patient, an infective process of the aortic cusps induced the formation of multiple abscesses in the left ventricle and in the right atrium. An annular abscess of the tricuspid valve was found. From the right atrium, an infected fistula spread through the atrial wall and perforated the epicardial surface of the right auricle. Aside from the rare occurrence of these complications in patients affected with infective endocarditis, these cases are of clinical interest because they raise the problem of the need of greater sensitivity to the diagnosis of endocarditis and proper diagnostic approach.- - - - - - - - - - ranking = 0.029510720867672keywords = aneurysm (Clic here for more details about this article) |
10/226. Mycotic aneurysm of the abdominal aorta in a patient undergoing hemodialysis: an unusual complication of staphylococcus aureus bacteremia.When staphylococcus aureus is repeatedly positive in blood cultures even under effective antibiotics therapy (vancomycin, teicoplanin, or rifampin), computed tomography scan and sonography should be performed early to exclude mycotic aneurysm of the deeply seated arteries, especially in patients with abdominal aortic calcification. Before 1990, the most common causative organism of suprarenal aortic mycotic aneurysm was salmonella; since 1990, it has been gram-positive cocci (i.e., streptococcus and Staphylococcus) rather than gram-negative bacilli (i.e., salmonella), possibly because of the more invasive procedures performed in clinical settings, but this hypothesis needs further investigation.- - - - - - - - - - ranking = 0.17706432520603keywords = aneurysm (Clic here for more details about this article) |
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