<i>In Situ </i>Ascending Aorta Replacement with Bovine Pericardial Roll Graft for MRSA Graft Infection

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  • Hayashida Yoshio
    Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital Fukuoka University Hospital Cardiovascular Surgery
  • Morishige Noritugu
    Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital
  • Osumi Masahiro
    Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital
  • Fujii Mituru
    Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital

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  • MRSA 人工血管感染に対してウシ心膜ロールで上行大動脈再置換術を行った1例

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<p>We report an interesting case of thoracic vascular graft infection treated by in situ replacement using bovine pericardial roll. A 65-year-old man who had undergone graft replacement of ascending aorta for acute type A aortic dissection 9 months prior was admitted to our hospital with purulent discharge from his chest wound. Fluid accumulation surrounding the vascular graft was detected by chest CT, and methicillin-resistant Staphylococcus aureus (MRSA) was positive from his blood culture. These findings led to a diagnosis of aortic graft infection. We gave the antibiotics intravenously, opened the abscess cavity around the infected graft, and irrigated with 0.04% gentian violet solution for 6 months, but failed to control the graft infection. Then we did redo replacement of the ascending aortic vascular graft using a bovine pericardial roll graft with a concomitant omental flap wrapping and obtained successful healing of the graft infection. During follow-up, no recurrent infection occurred, however he died of acute subdural hematoma 8 months after surgery. In situ replacement of the infected vascular grafts using a bovine pericardial roll graft with a concomitant omental flap wrapping may be an option for treating infected aortic grafts.</p>

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