Vendramin Igor, Peghin Maddalena, Tascini Carlo, Livi Ugolino
Cardiothoracic Department, University Hospital, Udine, Italy.
Division of Infectious Diseases, Department of Medicine, University Hospital, Udine, Italy.
Eur J Cardiothorac Surg. 2020 Aug 30. doi: 10.1093/ejcts/ezaa292.
Mycobacterium chimaera infections have been associated with contamination of a heater-cooler unit used during cardiopulmonary bypass procedures since 2006. Mycobacterium chimaera is a slow-growing non-tuberculous mycobacterium responsible for an infection, which is difficult to treat and has often a devastating course. Until now, M. chimaera infection has been shown to occur up to 8 years after operation. We report a patient presenting with an aortic pseudoaneurysm who developed M. chimaera infection 12 years after repair of an acute type A aortic dissection with graft replacement of the ascending aorta and stent-grafting of the arch. As far as we know, this is the case with the longest incubation period of M. chimaera infection. The present experience indicates that all patients who underwent open heart procedures since 2006 with such heater-cooler unit model should be closely followed up regardless of time of index surgery.
自2006年以来，嵌合体分枝杆菌感染一直与体外循环手术中使用的热交换器污染有关。嵌合体分枝杆菌是一种生长缓慢的非结核分枝杆菌，可导致感染，这种感染难以治疗，且病程往往具有毁灭性。到目前为止，嵌合体分枝杆菌感染已被证明可在术后长达8年发生。我们报告了一名患有主动脉假性动脉瘤的患者，该患者在急性A型主动脉夹层修复并置换升主动脉及进行主动脉弓支架植入术后12年发生了嵌合体分枝杆菌感染。据我们所知，这是嵌合体分枝杆菌感染潜伏期最长的病例。目前的经验表明，自2006年以来使用这种热交换器型号进行心脏直视手术的所有患者，无论首次手术时间如何，都应密切随访。
