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THE JOURNAL OF CARDIOVASCULAR SURGERY

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The Journal of Cardiovascular Surgery 1998 June;39(3):303-5

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Intravascular ultrasound diagnosis of aortic graft infection

Duda D. H., Schott U., Raygrotzki S.*

From the Department of Radiology, Division of Diagnostic Radiology, *Department of Surgery, Division of Thoracic, Cardiac & Vascular Surgery Eberhard-Karls-Universität Tübingen, Germany


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Background. To ­assess ­the val­ue of intra­-aor­tic ultra­sound (US) ­for diag­nos­ing intra­pros­thet­ic veg­e­ta­tions in atyp­i­cal aor­tic ­graft infec­tion.
Methods. A 66-­year-­old ­man pre­sent­ed ­with ­fever 12 ­months ­after emer­gen­cy inser­tion of a ­straight infra­ren­al aor­tic ­graft ­because of rup­ture of an inflam­ma­to­ry abdom­i­nal aneu­rysm. Blood cul­tures, leu­ko­cyte ­scan, trans­ab­dom­i­nal US ­study, ­and dig­i­tal angio­gra­phy ­were neg­a­tive. Spiral CT ­was equi-vocal. The ­patient ­was ­imaged ­with a mechan­i­cal­ly rotat­ing US trans­duc­er at 12.5-MHz ­from ­inside ­the ­graft.
Results. Intravascular cath­e­ter ultra­sound ­showed ­mobile ­lesions at ­the ­graft ­wall in ­the ­absence of per­i­pros­thet­ic ­fluid. Immediately ­after ­the pro­ce­dure ­the ­patient devel­oped sev­er­al ­small cuta­ne­ous sep­tic infarc­tions on ­both ­feet. At oper­a­tion ­the pres­ence of ­graft infec­tion ­was con­firmed.
Conclusions. This ­case ­report sug­gests ­that intra-­aor­tic US ­may con­sti­tute a help­ful adjunc­tive modal­ity in sus­pect­ed atyp­i­cal infec­tion of pros­thet­ic aor­tic ­grafts.

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