Yamasaki Manabu, Abe Kohei, Misumi Hiroyasu, Ito Joji, Nakanishi Yusuke, Kawazoe Kohei
Department of Cardiovascular Surgery, St. Luke's International Hospital, 9-1 Akashicho, Chuoku, Tokyo, 104-8560, Japan.
Surg Today. 2015 Dec;45(12):1575-8. doi: 10.1007/s00595-015-1148-9. Epub 2015 Mar 13.
While the incidence of endograft infection is very low, the treatment is difficult when it occurs. We herein present the case of a 52-year-old male who had undergone a graft replacement in the proximal descending thoracic aorta for dissected aortic aneurysm (DA) 6 years previously and hybrid surgery 2 years previously, which consisted of an abdominal graft replacement, visceral and renal debranching surgery and endovascular surgery for a ruptured abdominal DA and residual thoracoabdominal DA. Following collapse from septic shock due to an endograft infection, we performed an in situ reconstruction of the entire thoracoabdominal aorta following intensive antibiotic therapy and 2 preoperative CT-guided percutaneous interventions. He was discharged 4 weeks after the surgery without any complications.
虽然血管内移植物感染的发生率很低，但一旦发生，治疗起来很困难。我们在此报告一例52岁男性患者，他6年前因主动脉夹层动脉瘤（DA）在胸降主动脉近端接受了移植物置换术，2年前接受了杂交手术，包括腹部移植物置换术、内脏和肾去分支手术以及针对破裂性腹部DA和残留胸腹主动脉夹层的血管内手术。因血管内移植物感染导致感染性休克而出现虚脱后，我们在强化抗生素治疗和术前2次CT引导下经皮介入治疗后，对整个胸腹主动脉进行了原位重建。术后4周他出院，无任何并发症。
