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The Annals of Thoracic Surgery, Vol 50, 982-983, Copyright © 1990 by The Society of Thoracic Surgeons

ARTICLES

Management of mycotic rupture of the ascending aorta after heart-lung transplantation

J Albes, A Haverich, J Freihorst, H von der Hardt and F Manthey-Stiers
Department of Pediatric Pulmonology, Hannover Medical School, Federal Republic of Germany.

A 19-year-old woman underwent heart-lung transplantation for obstructive bronchiolitis. Eleven days later mycotic rupture of the ascending aorta occurred. Emergency cardiopulmonary bypass was instituted via the femoral vessels and the chest was reopened under cardiac massage. Perforation of the aorta at the site of insertion of the cardioplegic cannula in the donor aorta was seen. Under circulatory arrest the infected area was excised, a pericardial patch plasty was performed, and the region was covered with a muscle flap. Postoperatively, Candida albicans was found in the excised specimen of the aorta, in drainage fluid, and in the bronchoalveolar lavage. High doses of antimycotics were administered intravenously and for irrigation of the mediastinum, which resulted in an eradication of fungi in all cultures 7 days later. Six weeks after reoperation the patient was discharged home, and she remains well 9 months postoperatively.


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J. Wippermann, J. M. Albes, H. Brandes, and T. Wahlers
Punch-hole aneurysm of the ascending aorta after coronary artery bypass surgery
Interactive CardioVascular and Thoracic Surgery, September 1, 2003; 2(3): 385 - 386.
[Abstract] [Full Text] [PDF]


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