Tano K, Ichikawa Y, Kinoshita H
Department of Cardiovascular Surgery, Japanese Red Cross Society Kochi Hospital, Kochi, Japan.
Kyobu Geka. 2009 Dec;62(13):1166-9.
We report a successful surgical treatment of an aortic arch rupture caused by methicillin-resistant Staphylococcus aureus (MRSA) infection in a 72 years old man who had back pain and hemoptysis as symptoms. Computed tomography showed enlargement of the aortic arch within just 4 days. We diagnosed the state of impending rupture of inflammatory aneurysm and performed emergent operation. The upper lobe of the left lung adhered firmly to the site of rupture and sealed as the barrier to prevent bleeding. The aorta was replaced with a dacron graft in situ after entire resection of infected tissue and sufficient irrigation of the pleural cavity. The patient was treated with vancomycin and minocyclin for MRSA infection. The postoperative course of the patient was uneventful. This suggests that an early operation and a proper use of antibiotics lead to a successful clinical result in patient with infectious aortic rupture.