Xu Lingling, Lin Shan, Yang Yali
Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hubei Province Key Laboratory of Molecular Imaging, 1277 Jiefang Ave, Wuhan, 430022, China.
J Cardiothorac Surg. 2020 May 13;15(1):94. doi: 10.1186/s13019-020-01128-9.
Perigraft abscess is a rare condition which constitutes a small proportion of aortic graft infection (AGI). Early diagnosis is very important for timely intervention and improving the survival rate of patients because of its significant morbidity and mortality.
A 24-year-old young male patient with a history of complicated total arch replacement using elephant trunk technique for acute DeBakey type-1 aortic dissection 6 months before visited our hospital with the chief complaint of persistent fever. Antibiotic treatment in local hospital was ineffective. Echocardiography showed liquid dark area around the aortic graft, and a computerized tomography angiography (CTA) was done for further evaluation of periaortic fluid collection which showed findings to suggest perigraft abscess. The patient underwent surgical debridement of the abscess and was found to have an abscess around the aortic graft which was drained followed by antibiotic treatment. The patient was discharged to his local hospital and recovered well at 2 month follow-up appointment.
This is a very rare case of aortic abscess around the graft that could successfully be managed by graft-conserving surgery, and it emphasizes the significance of early diagnosis of perigraft abscess in patients with aortic dissection surgery.
移植物周围脓肿是一种罕见病症，在主动脉移植物感染（AGI）中占比很小。因其具有较高的发病率和死亡率，早期诊断对于及时干预和提高患者生存率非常重要。
一名24岁年轻男性患者，6个月前因急性DeBakey I型主动脉夹层采用象鼻技术进行了复杂的全弓置换术，现因持续发热为主诉前来我院就诊。当地医院的抗生素治疗无效。超声心动图显示主动脉移植物周围有液性暗区，遂进行计算机断层血管造影（CTA）以进一步评估主动脉周围积液，结果提示移植物周围脓肿。患者接受了脓肿的手术清创，发现主动脉移植物周围有脓肿，引流后进行抗生素治疗。患者出院回到当地医院，在2个月的随访预约中恢复良好。
这是一例非常罕见的移植物周围主动脉脓肿病例，通过保留移植物的手术成功治疗，强调了主动脉夹层手术患者移植物周围脓肿早期诊断的重要性。
