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J Endovasc Ther. 2010 Jun;17(3):395-8. doi: 10.1583/10-3033.1.

Endovascular repair of ascending aortic rupture: effectiveness of a fenestrated stent-graft.

Author information

1
Cardiovascular Center, Yokohama City University Medical Center, Yokohama, Japan. k_uchida@yokohama-cu.ac.jp

Abstract

PURPOSE:

To present a technique for endovascular treatment using a fenestrated stent-graft in a patient with ascending aortic rupture in the setting of methicillin-resistant Staphylococcus aureus infection.

CASE REPORT:

A 62-year-old woman had undergone mastectomy and radiotherapy twice for breast cancer and then coronary artery bypass grafting (CABG). She developed sternal osteomyelitis 5 years after the CABG. Sternectomy and negative-pressure wound drainage were performed, but the infection did not resolve. Ascending aortic rupture occurred 5 months after sternectomy. Endovascular therapy was considered the only effective means of achieving hemostasis. A custom-designed fenestrated stent-graft was deployed from the ascending aorta to the proximal descending aorta via a femoral artery approach without transient cardiac arrest. Bleeding completely stopped after surgery. The postoperative course was uneventful, and the inflammatory activity subsided on antibiotic therapy. At 7 months after surgery, the patient's recovery has been uneventful.

CONCLUSION:

Rupture of the ascending aorta associated with infection was successfully treated by stent-graft repair. The use of a custom-made, fenestrated stent-graft was an effective, lifesaving procedure for the management of this ascending aortic lesion.

PMID:
20557182
DOI:
10.1583/10-3033.1
[Indexed for MEDLINE]

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