Infected Abdominal Aortic Aneurysm with a Previous History of Coronary Artery Bypass Grafting with the Right Gastroepiploic Artery

Shinichi Imai	Kentaro Sawada	Eiji Nakamura
Shohei Yoshida	Hayato Fukuda	Satoru Tobinaga
Seiji Onitsuka	Shinichi Hiromatsu	Hidetoshi Akashi
Hiroyuki Tanaka

（Department of Surgery, Kurume University School of Medicine＊, Kurume, Japan）

We report a case of successful anatomical reconstruction with omentopexy of an infected abdominal aortic aneurysm（AAA）in a patient with a previous history of coronary artery bypass grafting with the right gastroepiploic artery. A 60-year-old man was referred to our institute because of fever and abdominal pain during hemodialysis for chronic renal failure. Antibiotic therapy was started after computed tomography revealed an infected abdominal aortic aneurysm. After infection control, surgical treatment was scheduled. At surgery, left axillo-bifemoral bypass was performed first, because it was unclear whether the omentum was large enough for omentopexy. At laparotomy, adequate omentum and infective AAA were confirmed. AAA repair using a rifampicin-soaked graft, and omentopexy were performed. Enterobacter aerogenes was detected from the resected aortic wall. After the operation, intravenous antibiotic was used for 25 days until CRP was normalized. One year follow-up showed no sign of re-infection.

 

Jpn. J. Cardiovasc. Surg. 45:84-88（2016）

Keywords：infected aneurysm;anatomic revascularization;extra-anatomic bypass;omentopexy;CABG