Mycotic aneurysm of the ascending aorta after coronary revascularization

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients With Thoracic Aortic Disease

“…Infection most often arises in a diseased aorta, either in a preexisting aneurysm, at the site of an atherosclerotic plaque, or at the site of some accidental or iatrogenic aortic trauma. Indeed, infected thoracic aortic aneurysms may arise as a late complication of cardiac surgery, often associated with postoperative mediastinitis, typically at the sites of aortic cannulation or anastomotic suture lines (200,201).…”

2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM Guidelines for the Diagnosis and Management of Patients with Thoracic Aortic Disease

“…Indeed, infected thoracic aortic aneurysms may arise as a late complication of cardiac surgery, often associated with postoperative mediastinitis, typically at the sites of aortic cannulation or anastomotic suture lines. 200,201 Various organisms can infect the aorta, with most infections being bacterial. Staphylococcus aureus and Salmonella are the organisms most commonly identified.…”

Mycotic aneurysm of the ascending aorta following CABG

“…Single cases of the development of mycotic aneurysms following such common procedures as coronary revascularisation or percutaneous transluminal coronary angioplasty have also been reported 23 7 …”

“…5 7 In contrast, the progress of non-mycotic aneurysms is estimated between 0.3 and 0.6 cm per year 1415 Factors thought to be responsible for such rapid enlargement are the virulence of the organisms and arterial blood pressure, which provides the expanding force; however, the latter is also a factor in the development of slowly progressing non-mycotic aneurysms 5…”

“…A surgical reconstruction with either aortic homograft or synthetic graft insertion in combination with prolonged administration of antibiotics has lowered mortality to 25% 36 7 11-13 Early diagnosis is important for successful treatment. We present two patients in whom coronary artery bypass graft surgery was complicated by the development of mycotic aneurysm of the ascending aorta.…”