초록접수 현황
| 17F-286 | 포스터 발표 |
Delayed Thoracic Endograft Infection with MultipleEnd-organ Involvement in Uncontrolled Diabetic Patient
Woo Sung Jang, Jae-Bum Kim, Nam Hee Park
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
Purpose : Thoracic endovascular aortic repair (TEVAR) is increasingly applied in clinical practice as a less invasive procedure for various thoracic aortic diseases. However, endograft infection after TEVAR is devastating complication and the management strategies are still challenging
Methods : A 66-year-old man was admitted with high fever and uncontrolled blood glucose level. The patient had a history of TEVAR 4-years ago due to traumatic aortic dissection. The abdominal CT scan showed prostate abscess, and microbiologic studies from prostate pus, urine, stool, and blood were identified as a Klebsiella pneumonia. The chest CT scan revealed multiple air-bubbles at the distal end of stent graft, and no evidence of leakage or fistula in esophagography. Massive antibiotic chemotheraphy was started and changed according to susceptibility. The laboratory findings of sepsis did not seem to be improved and his clinical courses were deteriorated. At the 7days of admission, surgical endograft explantation and aortic repair was done under the deep hypothermic circulatory arrest
Results : Immediate postoperative clinical signs were tolerable. The appropriate antibiotics were maintained and careful blood glucose control was achieved. However, the patient died due to uncontrolled sepsis 2 days after the operation
Conclusion : Infection of the thoracicic endograft is rare but fatal complication. The decision of the treatment modality and optimal surgical timing for this critical condition is still difficult with limited data. Preoperative infection control may be crucial for the patient survival.
Methods : A 66-year-old man was admitted with high fever and uncontrolled blood glucose level. The patient had a history of TEVAR 4-years ago due to traumatic aortic dissection. The abdominal CT scan showed prostate abscess, and microbiologic studies from prostate pus, urine, stool, and blood were identified as a Klebsiella pneumonia. The chest CT scan revealed multiple air-bubbles at the distal end of stent graft, and no evidence of leakage or fistula in esophagography. Massive antibiotic chemotheraphy was started and changed according to susceptibility. The laboratory findings of sepsis did not seem to be improved and his clinical courses were deteriorated. At the 7days of admission, surgical endograft explantation and aortic repair was done under the deep hypothermic circulatory arrest
Results : Immediate postoperative clinical signs were tolerable. The appropriate antibiotics were maintained and careful blood glucose control was achieved. However, the patient died due to uncontrolled sepsis 2 days after the operation
Conclusion : Infection of the thoracicic endograft is rare but fatal complication. The decision of the treatment modality and optimal surgical timing for this critical condition is still difficult with limited data. Preoperative infection control may be crucial for the patient survival.
책임저자: Nam Hee Park
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
발표자: Woo Sung Jang, E-mail : whiteuri09@gmail.com