A Case of Infected Type IIIb Aortic Dissection

(Department of Thoracic and Cardiovascular Surgery, Kawasaki Medical School, Kurashiki, Japan)

Takashi Miyake Hisao Masaki Ichiro Morita
Atsushi Tabuchi Atsuhisa Ishida Eishun Shishido
Kazuo Tanemoto
A 62-year-old man was admitted to our hospital because of acute aortic dissection (DeBakey type IIIb). Inflammatory findings were detected and methicillin-resistant staphylococcus aureus(MRSA)was detected by blood culture. Appropriate antibiotic therapy was begun but was ineffective. Repeated CT scans revealed dilation of the false lumen with thrombus and perianeurysmal inflammatory change in the lung. A diagnosis of infected aortic dissection was made. The patient was treated by resection of the descending aorta and placement of an in situ Dacron graft covered with a pedicled omental flap. An infected thrombus in the false lumen was confirmed by a positive MRSA culture. Computed tomography was found to be more sensitive in the diagnosis of infected aortic dissection. When the infection is not controlled with antibiotics, prompt surgical treatment should be performed.
 Jpn. J. Cardiovasc. Surg. 32:34-37(2003)