Endovascular Treatment for Ruptured Infected Descending Thoracic Aortic Aneurysm

(Department of Cardiovascular Surgery, Matsuyama Shimin Hospital and present address: Department of Cardiovascular Surgery, Kagawa Central Hospital*, Takamatsu, Japan)

Atsushi Aoki* Kenji Sangawa
Endovascular treatment with a hand-made stent graft was performed successfully for a ruptured infected descending thoracic aortic aneurysm in the patient under chronic hemodialysis. The patient was a 77-year-old man and hemodialysis was continued with a double lumen catheter because of internal shunt occlusion since November 2005. He developed MRSA sepsis around January 2006 and was treated with antibiotics. Left pleural effusion was drained on March 1st, 2006. Initially left effusion from the left side was fluently bloody, however it became bloody the next day. Enhanced CT revealed the descending thoracic aortic aneurysm and left hemo-thorax. He was referred to our service, and was transportedly via ambulance. Home made stent graft was deployed under local anesthesia 2h after the arrival. His hemodynamic status became stable and left pleural hematoma was removed by video assisted thoracic surgery 2 days after endovascular treatment. His postoperative course was uneventful and antibiotics were continued 4 weeks. He is doing well without any recurrence of infection 23 month after the surgery. Careful follow up is mandatory, and endovascular treatment would be useful for the ruptured infected aortic aneurysm.
@Jpn. J. Cardiovasc. Surg. 37: 276-280 (2008)