Successful stent graft repair of multiple thoracoabdominal mycotic aortic aneurysms in the presence of Kommerell diverticulum and complicated by aortoesophageal fistula

Debra S.T. Chong MBBS, MRCS , Hamish Hamilton FRCS , Jason Constantinou MD, FRCS , Meryl Davis FRCS , Muntzer Mughal FRCS , Krasnodar Ivancev MD, PhD
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Abstract

We describe the management of a woman who presented with synchronous mycotic aortic aneurysms of the aortic arch in the presence of Kommerell diverticulum, the distal thoracic, and the juxtarenal aorta. A staged stent graft repair was undertaken due to rapid expansion of the aneurysms, which involved placement of multiple thoracic quadruple-fenestrated and infrarenal bifurcated stent grafts. Despite complications of an aortoesophageal fistula and transitory spinal cord ischemia, she has been managed successfully and is doing well at 36 months. This case illustrates that stent graft repair of mycotic aneurysms can offer a successful treatment option in selected patients.

存在Kommerell憩室并并发主动脉食管瘘的多发胸腹真菌性主动脉瘤的支架成功修复
我们描述了一位出现Kommerell憩室、胸椎远端和肾旁主动脉的主动脉弓同步真菌性动脉瘤的女性患者的治疗方法。由于动脉瘤迅速扩张,我们采取了分阶段的支架修复,其中包括放置多个胸椎四开窗和肾下分叉支架。尽管出现了主动脉食管瘘和短暂性脊髓缺血的并发症,但她得到了成功的治疗,并在36个月时表现良好。这个病例说明支架移植修复真菌性动脉瘤可以提供一个成功的治疗选择在选定的患者。
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