Mycotic Pseudoaneurysm of the Aortic Arch

Authors

  • João Gonçalves Cardiothoracic Surgery Department, University Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Portugal
  • Eurídice Ângelo Cardiothoracic Surgery Department, University Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Portugal
  • Ricardo Ferreira Cardiothoracic Surgery Department, University Hospital Santa Maria, Centro Hospitalar Lisboa Norte, Portugal

DOI:

https://doi.org/10.48729/pjctvs.308

Abstract

A 59 year-old male presents with fever and left parasternal pain. Past medical history included arterial hypertension, dyslipidemia, smoking, obesity. His clinical exam was unremarkable. Both C-reactive protein and leucocytes were elevated. Chest computed tomography (CT) demonstrated a 18mm saccular pseudoaneurysm of the aortic arch with extensive adjacent densification and adenopathy (Figure 1 and 2). Methicillin-sensible Staphylococcus aureus was isolated from blood cultures. A transesophageal echocardiogram excluded endocarditis. Control Angio-CT after seven days showed a contained rupture and increase in diameter of the pseudoaneurysm. He underwent emergent surgery with circulatory arrest and anterograde cerebral perfusion; extensive resection of the pseudoaneurysmal aorta was performed, with reconstruction of the aortic arch using autologous pericardium, without implantation of foreign or synthetic material (Figure 3 and 4). He completed 4 weeks of Flucloxacillin IV, having been discharged under oral antibiotics.

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Published

05-10-2022

How to Cite

1.
Gonçalves J, Ângelo E, Ferreira R. Mycotic Pseudoaneurysm of the Aortic Arch. Rev Port Cir Cardiotorac Vasc [Internet]. 2022 Oct. 5 [cited 2023 Feb. 3];29(3):83-4. Available from: https://pjctvs.com/index.php/journal/article/view/308

Issue

Section

Images in Surgery

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