Okada S, Kaneko T, Ezure M, Satoh Y, Hasegawa Y, Koike N, Okonogi S, Takihara H
Department of Cardiovascular Surgery, Gunma Prefectural Cardiovascular Center, Maebashi, Japan.
Kyobu Geka. 2009 Feb;62(2):96-100.
We report 3 cases of endovascular stent-grafting (ESG) for mycotic thoracic aortic aneurysm. The case 1 was a rupture of pseudoaneurysm of the descending aorta caused by mediastinitis due to perforation of esophageal ulcer. The patient underwent emergent ESG for temporary control of the rupture. He underwent esophagus reconstruction 5 month after ESG. The case 2 was admitted due to inflammatory reaction. She was diagnosed with mycotic descending aortic aneurysm and underwent elective ESG because of her old age. Her postoperative course was uneventful and no infection recurred. The case 3 underwent ESG for a ruptured mycotic descending aortic aneurysm. But 113 days after ESG, he underwent ESG again for a ruptured endoleak of the stentgraft. His blood culture demonstrated methillin-resistant Staphylococcus aureus (MRSA). He died of rupture to bronchus and esophagus at 18th day after ESG. We believe that ESG is useful in high risk patients for temporary management of the rupture.
我们报告了3例采用血管内支架植入术（ESG）治疗霉菌性胸主动脉瘤的病例。病例1为食管溃疡穿孔导致纵隔炎引起降主动脉假性动脉瘤破裂。患者接受了急诊ESG以临时控制破裂。ESG术后5个月，他接受了食管重建术。病例2因炎症反应入院。她被诊断为霉菌性降主动脉瘤，由于年龄较大接受了择期ESG。她的术后过程顺利，未再发生感染。病例3因霉菌性降主动脉瘤破裂接受了ESG。但ESG术后113天，他因支架移植物内漏破裂再次接受ESG。他的血培养显示耐甲氧西林金黄色葡萄球菌（MRSA）。他在ESG术后第18天死于支气管和食管破裂。我们认为ESG对高风险患者临时处理破裂情况是有用的。
