Thoraco-abdominal Repair Of A Supraceliac Mycotic Pseudoaneurysm
Edward A. Andraos, MD, Muhammad M. Zubair, MD, Thomas E. MacGillivray, MD, Charudatta S. Bavare, MD.
Houston Methodist, Houston, TX, USA.
Thoraco-Abdominal Repair of Supraceliac Mycotic Pseudoaneurysm
Mycotic aortic aneurysms are an infrequently encountered pathology with an incidence as low as 0.85%.1 When it afflicts the abdominal aortic segment, the second most frequent site (31%)2, reconstructing the visceral vessels may present many pitfalls and challenges to the most experienced surgeons. In our video, we demonstrate our clinical experience with thoraco-abdominal repair of a supraceliac mycotic pseudoaneurysm (likely in the setting of a penetrating aortic ulcer) affecting a patient with recurrent hemodialysis graft infections presenting with septicemia and abdominal pain. Our focus is to display optimal exposure, techniques with aortic control/visceral perfusion/left heart bypass and feasibility of this procedure with a Cardiac/Vascular multidisciplinary approach. 1. FY Chan, ES Crawford, JS Coselli, et al.: In situ prosthetic graft replacement for mycotic aneurysms of the aorta. Ann Thorac Surg. 47:193-199 1989 2. KD Calligaro, DA DeLaurentis, MJ Dougherty: Venous anomalies encountered during abdominal aortic surgery. KD Caligaro MD Dougherty L Hollie Diagnosis and Treatment of Aortic and Peripheral Arterial Aneurysms. 1999 WB Saunders Philadelphia
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