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ULTIMO FASCICOLOTHE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Aprile;41(2):317-9

VASCULAR PAPERS 

 CASE REPORTS

Implantation of a composite bifurcated cryopreserved aorto-iliac-femoral homograft in a patient with Candida albicans endocarditis

Abad C., Maynar M. *, Ponce G., Chau O. *, Cárdenes M. A. **, Jiménez P. **, Betancor P. **

From the Depart­ment of ­Cardio-Vas­cular Sur­gery, *Vas­cular-­Interventional ­Radiology and **­Internal Med­i­cine Uni­ver­sity Hos­pital N. S. del ­Pino Las ­Palmas de ­Gran ­Canaria, ­Spain

A 35 ­year old ­woman, ­cocaine ­addict, suf­fered Can­dida albi­cans ­aortic ­valve endo­car­ditis com­pli­cated ­with embol­isa­tion of ­infected veg­e­ta­tions in the ­distal abdom­inal ­aorta. She under­went suc­cessful ­staged ­aortic ­valve replace­ment fol­lowed by trans­aortic and trans­fe­moral throm­bec­tomy. One ­month ­later an arter­i­o­gram dis­closed par­tial occlu­sion of the ­left ­iliac ­artery, bilat­eral aneu­rysmal degen­er­a­tion of ­both ­iliac ­arteries and ­right ­iliac ­artery-­right ­iliac ­vein fis­tula. She was oper­ated ­again, per­forming re-lap­a­rotomy and re-explo­ra­tion. A com­posite bifur­cated cryo­pre­served homo­graft was ­implanted end-to-­side ­between the infra­renal abdom­inal ­aorta, ­right ­external ­iliac ­artery and ­left ­common ­femoral ­artery. The ­right ­iliac ­artery-­iliac ­vein fis­tula was oblit­er­ated ­with ­suture. The ­patient had an ­uneventful ­recovery but a ­relapsing ­arterio-­venous fis­tula was diag­nosed by arter­i­og­raphy. ­Three ­months ­later she under­went per­cut­aneous trans­lu­minal clo­sure of the ­reopened fis­tula. At ­present, 17 ­months ­after the implan­ta­tion of the homo­graft, the ­patient is ­symptom-­free, on anti­fungal ­agents and ­with arte­ri­o­graphic and clin­ical evi­dence of a ­well-func­tioning arte­rial homo­graft.

lingua: Inglese


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