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用冷冻保存的主动脉同种异体移植物重建耐甲氧西林金黄色葡萄球菌感染的内脏旁主动脉假性动脉瘤。

reconstruction of an MRSA-infected paravisceral aortic pseudoaneurysm with cryopreserved aortic allograft.

作者信息

Banga Peter, Legeza Peter, Szeberin Zoltán

机构信息

Department of Vascular Surgery, Semmelweis University, Budapest, Hungary.

出版信息

Interv Med Appl Sci. 2019 Jun;11(2):122-124. doi: 10.1556/1646.11.2019.11.

Abstract

OBJECTIVES

Treatment of paravisceral aortic infections poses several challenges because standard therapy with excision of all infected tissues and extraanatomic reconstruction is frequently not possible without jeopardizing visceral perfusion. reconstruction with rifampin-soaked prosthetic graft or endovascular repair with stent grafts runs the risk of reinfection. We present a case of a paravisceral aortic infection, where cryopreserved allograft was used for the reconstruction of the aorta.

METHODS

Medical documentation and CT angiography studies were retrospectively reviewed for a patient in a tertiary care center.

RESULTS

A 62-year-old male patient presented with an infected pseudoaneurysm of the paravisceral aorta at the level of the celiac artery. He had previously undergone multiple orthopedic surgical interventions and developed methicillin-resistant infections. We successfully repaired the paravisceral pseudoaneurysm with excision of all infected tissues and aortic replacement with a cryopreserved allograft.

CONCLUSION

In case of infected aortic pseudoaneurysm, the use of cryopreserved aortic allograft is a reliable choice for reconstruction of the aorta.

摘要

目的

内脏旁主动脉感染的治疗面临诸多挑战,因为在不危及内脏灌注的情况下,常无法采用切除所有感染组织并进行解剖外重建的标准疗法。使用浸有利福平的人工血管进行重建或采用支架型人工血管进行血管腔内修复存在再次感染的风险。我们报告一例内脏旁主动脉感染病例,该病例使用了冷冻保存的同种异体移植物进行主动脉重建。

方法

对一家三级医疗中心的一名患者的医疗记录和CT血管造影研究进行了回顾性分析。

结果

一名62岁男性患者,在腹腔动脉水平出现内脏旁主动脉感染性假性动脉瘤。他此前接受过多次骨科手术,并发生了耐甲氧西林感染。我们成功切除了所有感染组织,并用冷冻保存的同种异体移植物置换主动脉,修复了内脏旁假性动脉瘤。

结论

对于感染性主动脉假性动脉瘤,使用冷冻保存的主动脉同种异体移植物是主动脉重建的可靠选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b538/7044533/aea6a1fbe953/imas-11-02-11_f001.jpg

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