| A Case of Mycotic Pseudoaneurysm of the Brachiocephalic Artery |
(Yokohama City University Medical Center
Cardiovascular Center, Yokohama, Japan and First Department
of Surgery, Yokohama City University*, Yokohama, Japan)
| Motohiko Goda |
Kiyotaka Imoto |
Shinichi Suzuki |
| Keiji Uchida |
Toshiki Hatsune |
Yoshinori Takanashi* |
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A 61-year-old man admitted
to another hospital because of cerebral infarction had
fever (about 39°C). Computed tomographic scanning revealed
a pseudoaneurysm of the brachiocephalic artery, accompanied
by pericardial fluid. The patient was transferred to our
hospital. Culture studies of a sample of pericardial fluid
revealed Staphylococcus aureus. A mycotic pseudoaneurysm
of the brachiocephalic artery was diagnosed. Antibiotics
were given for about 2 weeks after transfer to our hospital.
Surgery was performed after the inflammation subsided.
The pseudoaneurysm was incised during circulatory arrest.
A hole measuring 2 cm in diameter was found at the origin
of the brachiocephalic artery. The hole was sealed with
an autologous arterial patch, made from a 3-cm section
of the right axillary artery. The axillary artery was
reconstructed by end-to-end anastomosis. After surgery,
infection was controlled by means of systemic antibiotics
and closed mediastinal lavage. The patient was discharged
from the hospital in good condition 160 days after surgery.
To date, there has been no flare-up of infection.
Jpn. J. Cardiovasc. Surg. 35: 164-167 (2006) |
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