Download PDF
CC BY 4.0 · Aorta (Stamford) 2019; 07(05): 137-139
DOI: 10.1055/s-0039-3401012
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Necrotizing Infection of the Aortic Arch: Reconstruction Utilizing Unusual Extra-anatomic Bypass Grafts to Reroute Cerebral Blood Flow

Jonathan M. Hemli
1   Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York
,
Byron D. Patton
1   Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York
,
S. Jacob Scheinerman
1   Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York
,
Derek R. Brinster
1   Department of Cardiovascular and Thoracic Surgery, Lenox Hill Hospital/Northwell Health, New York, New York
› Author Affiliations Funding None.
Further Information

Publication History

04 May 2018

19 October 2019

Publication Date:
04 February 2020 (online)

   Permissions and Reprints

Abstract

Destructive infections of the aortic arch and great vessels are challenging to manage. We describe a novel technique for debranching the right cerebral and upper extremity arteries via composite extra-anatomic bypasses from the femoral artery, with subsequent homograft in-line reconstruction of the arch, in a patient with Staphylococcus sepsis and necrosis of the arch and great vessels.

Keywords

extra-anatomic bypass - infective aortitis - homograft
 

  • References

  • 1 Kahlberg A, Melissano G, Tshomba Y, Leopardi M, Chiesa R. Strategies to treat thoracic aortitis and infected aortic grafts. J Cardiovasc Surg (Torino) 2015; 56 (02) 269-280
    PubMedGoogle Scholar
  • 2 Hsu RB, Lin FY. Surgery for infected aneurysm of the aortic arch. J Thorac Cardiovasc Surg 2007; 134 (05) 1157-1162
    CrossrefPubMedGoogle Scholar
  • 3 Hemli JM, , R DeLaney ER, Dholakia KR. , et al. Rethinking the paradigm: modern approach to proximal aortic reconstruction demonstrates excellent outcomes. Heart Surg Forum 2017; 20 (03) E092-E097
    PubMedGoogle Scholar
  • 4 Inoue H, Iguro Y, Ueno M, Yamamoto K. Extra-anatomic bypass operation for an infected aortic arch aneurysm with broad mediastinal abscess: a case report. Ann Vasc Dis 2015; 8 (03) 246-248
    CrossrefPubMedGoogle Scholar
  • 5 Molacek J, Treska V, Baxa J, Certik B, Houdek K. Acute conditions caused by infectious aortitis. Aorta (Stamford) 2014; 2 (03) 93-99
    Article in Thieme ConnectPubMedGoogle Scholar
  • 6 Okada K, Yamanaka K, Sakamoto T. , et al. In situ total aortic arch replacement for infected distal aortic arch aneurysms with penetrating atherosclerotic ulcer. J Thorac Cardiovasc Surg 2014; 148 (05) 2096-2100
    CrossrefPubMedGoogle Scholar
  • 7 Stellmes A, Von Allmen R, Derungs U. , et al. Thoracic endovascular aortic repair as emergency therapy despite suspected aortic infection. Interact Cardiovasc Thorac Surg 2013; 16 (04) 459-464
    CrossrefPubMedGoogle Scholar
  • 8 Garg N, Kalra M. Novel extra-anatomic intra-abdominal reconstruction for treatment of paravisceral aortic infection. J Vasc Surg 2012; 55 (02) 599-602
    CrossrefPubMedGoogle Scholar