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左心室辅助装置(LVAD)患者真菌性内脏动脉瘤的成功管理及应对LVAD术后挑战

Successful management of mycotic visceral aneurysms in a LVAD patient and navigating LVAD postoperative challenges.

作者信息

Wermine Kendall, Gohar Salman, Milhoan Rusty, Youree Bryan, Ramarathnam Vivek, Alqaim Mohammad

机构信息

Department of Surgery, Baylor Scott & White All Saints Medical Center Fort Worth, Fort Worth, TX.

Department of Advanced Heart Failure, Baylor Scott & White All Saints Medical Center Fort Worth, Fort Worth, TX.

出版信息

J Vasc Surg Cases Innov Tech. 2024 Dec 24;11(2):101715. doi: 10.1016/j.jvscit.2024.101715. eCollection 2025 Apr.

DOI:10.1016/j.jvscit.2024.101715
PMID:39896821
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11787573/
Abstract

This report presents a unique case of concurrent mycotic aneurysms in a 64-year-old male left ventricular assist device (LVAD) recipient. Initially admitted with odontogenic maxillary fungal sinusitis and fungemia, he later presented to our clinic with significant weight loss, fatigue, and LVAD complications. Imaging revealed a large complex mid-superior mesenteric artery aneurysm with multiple associated jejunal branches and a ruptured splenic aneurysm. Although these aneurysms were successfully managed, it is important to note the challenges in postoperative care, including anticoagulation-related complications such as post-splenectomy hematoma and intracranial bleeding. This case highlights the delicate balance between therapeutic interventions and managing LVAD-related complexities.

摘要

本报告介绍了一名64岁男性左心室辅助装置(LVAD)接受者并发霉菌性动脉瘤的独特病例。该患者最初因牙源性上颌真菌性鼻窦炎和真菌血症入院,后来因体重显著减轻、疲劳和LVAD并发症前来我院就诊。影像学检查发现一个巨大的复杂性肠系膜上动脉中部动脉瘤,伴有多个相关的空肠分支以及一个破裂的脾动脉瘤。尽管这些动脉瘤得到了成功治疗,但需要注意术后护理中的挑战,包括抗凝相关并发症,如脾切除术后血肿和颅内出血。该病例凸显了治疗干预与处理LVAD相关复杂性之间的微妙平衡。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d032/11787573/5ff35947e0bd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d032/11787573/5ff35947e0bd/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d032/11787573/5ff35947e0bd/gr1.jpg

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本文引用的文献

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Laparoscopic cholecystectomy after percutaneous transhepatic gallbladder drainage for acute cholecystitis in a patient with a left ventricle assist device: A case report and brief review of the literature (with video).左心室辅助装置患者经皮经肝胆道引流术后行腹腔镜胆囊切除术治疗急性胆囊炎:病例报告及文献简要回顾(附视频)
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Management of Intracranial Hemorrhage in Patients with a Left Ventricular Assist Device: A Systematic Review and Meta-Analysis.
左心室辅助装置患者颅内出血的管理:系统评价与荟萃分析
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