[Sterile Peri-graft Abscess of the Aortic Arch Treated With a Pedicled Omental Flap:Report of a Case].

Abstract

A 73-year-old woman underwent total arch replacement with an open stent graft for a distal arch thoracic aortic aneurysm. Six months later, purulent discharge appeared from the upper edge of the median sternotomy wound. She had no fever, inflammatory markers were minimal, and repeated bacterial, fungal, and mycobacterial cultures were negative. Computed tomography (CT) revealed a peri-graft abscess extending to the upper mediastinum. Because local wound care failed, redo sternotomy, thorough irrigation, and pedicled omental flap filling around the graft were performed nine months after the initial operation. Intraoperative cultures were also negative, and the lesion was diagnosed as a sterile peri-graft abscess. She has remained free from recurrence for one year after reoperation.