McCann Michael, Stamp Nikki, Larbalestier Robert
Department of Cardiothoracic Surgery and Transplantation, Fiona Stanley Hospital, Perth, Western Australia, Australia.
BMJ Case Rep. 2019 Sep 6;12(9):e230204. doi: 10.1136/bcr-2019-230204.
Infections of proximal aortic vascular grafts are a catastrophic complication of aortic surgery. Despite aggressive antimicrobial and surgical intervention, mortality and reinfection rates remain significant. Here, we describe a man aged 71 years with a medical history of bioprosthetic aortic valve with aortic arch replacement (modified Bentall's procedure), who developed a large periprosthetic abscess due to 7 years after his initial surgery. The patient's preference was to avoid redo surgery, however despite high-dose intravenous flucloxacillin and oral rifampicin therapy, there was rapid progression of the abscess, necessitating urgent surgery. Notwithstanding the burden of infection, the patient underwent successful surgical excision and graft re-implantation and remains independent and well, almost 2 years postoperatively.
近端主动脉血管移植物感染是主动脉手术的一种灾难性并发症。尽管采取了积极的抗菌和手术干预措施，但死亡率和再感染率仍然很高。在此，我们描述了一名71岁男性，有生物人工主动脉瓣置换主动脉弓（改良Bentall手术）病史，在初次手术后7年因感染形成了一个大的人工瓣膜周围脓肿。患者倾向于避免再次手术，然而，尽管给予了大剂量静脉注射氟氯西林和口服利福平治疗，脓肿仍迅速进展，需要紧急手术。尽管感染负担很重，但患者仍成功接受了手术切除和移植物重新植入，术后近2年仍保持独立且状况良好。
