scholarly journals Infectious Rupture of a Dissecting Thoracoabdominal Aortic Aneurysm Due to Citrobacter freundii

2021 ◽  
Author(s):  
Masafumi Hashimoto ◽  
Kenji Mogi ◽  
Manabu Sakurai ◽  
Tomoki Sakata ◽  
Kengo Tani ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Citrobacter Freundii ◽  
Aortic Replacement ◽  
Thoracoabdominal Aortic Replacement ◽  
Pseudomembranous Enteritis

Here we describe a case involving an elderly man with Citrobacter freundii-associated infectious rupture of a dissecting thoracoabdominal aortic aneurysm. We performed emergency thoracoabdominal aortic replacement using a rifampicin-soaked prosthetic graft and omental flap wrapping. The patient was discharged on postoperative day 255, although he experienced pseudomembranous enteritis and paraplegia.

scholarly journals A 60-year-old woman with asymptomatic total thoracic–abdominal aortic aneurysm

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianying Deng ◽  
Wei Liu
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Aortic Aneurysm ◽  
Effective Treatment ◽  
Clinical Symptoms ◽  
Aortic Aneurysms ◽  
Case Presentation ◽  
Second Stage ◽  
Aortic Replacement ◽  
Abdominal Aortic ◽  
Thoracoabdominal Aortic Replacement

Abstract Introduction Total thoracic–abdominal aortic aneurysm is a rare disease in cardiovascular surgery, with high surgical risk and high mortality. Surgery is considered the most effective treatment for total aortic aneurysms. Case presentation Our group admitted a 60-year-old female patients with asymptomatic complex total thoracic–abdominal aortic aneurysm, and successfully performed two-staged surgery, namely Bentall + Sun’s operation in the first-stage and thoracoabdominal aortic replacement in the second-stage. The results of the surgery were satisfactory. Conclusions Patients with total thoracic–abdominal aortic aneurysm may not have typical clinical symptoms and require a careful and comprehensive physical examination and related auxiliary examinations by clinicians. Staged repair of total thoracic–abdominal aortic aneurysms is still a safe and effective treatment.

Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection

2005 ◽  
Vol 13 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Yukio Kuniyoshi ◽  
Kageharu Koja ◽  
Kazufumi Miyagi ◽  
Tooru Uezu ◽  
Satoshi Yamashiro ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Graft Infection ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Thoracoabdominal Aorta ◽  
Omental Wrapping ◽  
Hospital Deaths

Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 ± 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.

scholarly journals A Case of False-aneurysm Due to Prosthetic Graft Dilatation after Thoracoabdominal Aortic Aneurysm Repair.

1996 ◽  
Vol 25 (4) ◽  
pp. 268-270 ◽  
Author(s):  
Mitsuhiro Yamamura ◽  
Takashi Miyamoto ◽  
Shinsho Maeda ◽  
Katsuhiko Yamashita ◽  
Seisuke Nakata ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
False Aneurysm ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Prosthetic Graft ◽  
Thoracoabdominal Aortic Aneurysm Repair ◽  
Aneurysm Repair ◽  
Aortic Aneurysm Repair

scholarly journals Rupture of a dissecting thoracoabdominal aortic aneurysm due to Citrobacter freundii infection

2021 ◽  
Vol 9 (9) ◽  
Author(s):  
Masafumi Hashimoto ◽  
Kenji Mogi ◽  
Manabu Sakurai ◽  
Tomoki Sakata ◽  
Kengo Tani ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Citrobacter Freundii

scholarly journals Collateral Formation from Left Lateral Thoracic Artery to the Adamkiewicz Artery

Aorta ◽  
2021 ◽  
Author(s):  
Toshihiro Fukui ◽  
Jun Takaki ◽  
Ken Okamoto
Keyword(s):  
Computed Tomography ◽  
Aortic Aneurysm ◽  
Neurological Deficit ◽  
Thoracoabdominal Aortic Aneurysm ◽  
Multidetector Row Computed Tomography ◽  
Collateral Vessel ◽  
Lateral Thoracic Artery ◽  
Aortic Replacement ◽  
Adamkiewicz Artery ◽  
Collateral Formation

AbstractA 68-year-old man who had undergone descending thoracic aortic replacement was referred to our hospital with a thoracoabdominal aortic aneurysm. During the original surgery, the Adamkiewicz artery was directly reconstructed. However, multidetector row computed tomography showed occlusion of the reconstructed artery at its orifice, with supply by a collateral vessel from the left lateral thoracic artery. With careful incision to avoid damage to the collateral vessel, no postoperative neurological deficit was observed.

scholarly journals The role of the pedicle omental flap in ruptured abdominal aortic aneurysm: a case report and literature review

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110281
Author(s):  
Marius Fodor ◽  
Sergiu Samuila ◽  
Lucian Fodor
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Mortality Rate ◽  
Aortic Aneurysm ◽  
Surgical Repair ◽  
Prosthetic Graft ◽  
Omental Flap ◽  
Graft Occlusion ◽  
Open Surgical Repair ◽  
Abdominal Aortic

A ruptured infrarenal abdominal aortic aneurysm (rAAA) is associated with an in-hospital mortality rate of 40% and an overall mortality rate of 60–80%. Open surgical repair for rAAA remains the principal method of treatment when endovascular repair is not available. Graft infection occurs in 1–4% of patients at 5 years, with a high incidence following emergency treatment. Other graft-related complications include pseudoaneurysm, graft occlusion and aorto-enteric fistula. This case report describes a 66-year-old male patient that was admitted to hospital complaining of intense abdominal pain, low blood pressure and tachycardia. He was diagnosed with a rAAA and treated using segmental resection of the abdominal aorta followed by reconstruction with a synthetic Dacron prosthesis. A pedicle omental flap was wrapped around the prosthetic graft and it was also used to fill the retroperitoneal cavity in order to reduce the risk of graft-related complications. Computed tomography angiography after 6 months showed good integration of the aortic prosthetic graft and the viability of the omental flap. In our opinion, vascular surgeons should consider the pedicle omental flap when they perform open surgical repair for rAAA in order to reduce the incidence of graft-related complications.

Epigenetic Profiling Identifies Novel Genes for Ascending Aortic Aneurysm Formation with Bicuspid Aortic Valves

2015 ◽  
Vol 18 (4) ◽  
pp. 134 ◽  
Author(s):  
Asad A Shah
Keyword(s):  
Gene Expression ◽  
Aortic Aneurysm ◽  
Methylation Status ◽  
Aortic Aneurysms ◽  
Aortic Valves ◽  
Ascending Aortic Aneurysm ◽  
Novel Genes ◽  
Aneurysm Formation ◽  
Aortic Replacement ◽  
Bicuspid Aortic Valves

<p><strong>Background:  </strong>Bicuspid aortic valves predispose to ascending aortic aneurysms, but the mechanisms underlying this aortopathy remain incompletely characterized.  We sought to identify epigenetic pathways predisposing to aneurysm formation in bicuspid patients.</p><p><strong>Methods:  </strong>Ascending aortic aneurysm tissue samples were collected at the time of aortic replacement in subjects with bicuspid and trileaflet aortic valves.  Genome-wide DNA methylation status was determined on DNA from tissue using the Illumina 450K methylation chip, and gene expression was profiled on the same samples using Illumina Whole-Genome DASL arrays.  Gene methylation and expression were compared between bicuspid and trileaflet individuals using an unadjusted Wilcoxon rank sum test.  </p><p><strong>Results:  </strong>Twenty-seven probes in 9 genes showed significant differential methylation and expression (P&lt;5.5x10<sup>-4</sup>).  The top gene was protein tyrosine phosphatase, non-receptor type 22 (<em>PTPN22</em>), which was hypermethylated (delta beta range: +15.4 to +16.0%) and underexpressed (log 2 gene expression intensity: bicuspid 5.1 vs. trileaflet 7.9, P=2x10<sup>-5</sup>) in bicuspid patients, as compared to tricuspid patients.  Numerous genes involved in cardiovascular development were also differentially methylated, but not differentially expressed, including <em>ACTA2</em> (4 probes, delta beta range:  -10.0 to -22.9%), which when mutated causes the syndrome of familial thoracic aortic aneurysms and dissections</p><p><strong>Conclusions:  </strong>Using an integrated, unbiased genomic approach, we have identified novel genes associated with ascending aortic aneurysms in patients with bicuspid aortic valves, modulated through epigenetic mechanisms.  The top gene was <em>PTPN22</em>, which is involved in T-cell receptor signaling and associated with various immune disorders.  These differences highlight novel potential mechanisms of aneurysm development in the bicuspid population.</p>

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