Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan.
Department of Cardiac Surgery, Michigan Medicine, Ann Arbor, Michigan.
Ann Thorac Surg. 2022 Apr;113(4):e271-e273. doi: 10.1016/j.athoracsur.2021.05.084. Epub 2021 Jun 29.
An 80-year-old man presented with a fast expanding 9.5-cm mycotic arch pseudoaneurysm. The right axillary and femoral arteries were cannulated. Through sternotomy, a reverse zone 2 arch replacement was performed with a 28-mm rifampin-soaked Hemashield aortic graft (Maquet, Wayne, NJ) graft with circulatory arrest. A 30-mm Coda balloon (Cook Medical, Bloomington, IN) was used to occlude the descending aorta, and the lower body was perfused through the femoral artery. The infected pseudoaneurysm was débrided and irrigated. A separate 28-mm rifampin-soaked Dacron graft was anastomosed to the proximal-descending aorta. The left subclavian artery was anastomosed to the proximal Dacron graft. Finally, the proximal and distal Dacron grafts were anastomosed together.
一位 80 岁男性患者出现了一个快速增大的 9.5 厘米真菌性弓部假性动脉瘤。右侧腋动脉和股动脉被插管。通过胸骨切开术，使用循环阻断技术，用 28 毫米利福平浸泡的 Hemashield 主动脉移植物（Maquet，Wayne，NJ）进行了反向区域 2 弓置换。使用 30 毫米的 Coda 球囊（Cook Medical，Bloomington，IN）来阻断降主动脉，通过股动脉对下半身进行灌注。感染性假性动脉瘤被清创和冲洗。单独的 28 毫米利福平浸泡的 Dacron 移植物与近端降主动脉吻合。左锁骨下动脉与近端 Dacron 移植物吻合。最后，将近端和远端的 Dacron 移植物一起吻合。
