Simultaneous Valve Replacement and Venous Patch Repair of Superior Mesenteric Artery Aneurysm Due to Infective Endocarditis: A Case Report
DOI:
https://doi.org/10.1532/HSF98.20061029Abstract
Background. Peripheral mycotic aneurysm development is a rare systemic complication of infective endocarditis.
Case report. We report on a case of a mycotic aneurysm of the superior mesenteric artery in a 66-year-old man with infective endocarditis of the mitral valve. After the mitral valve was replaced by a mechanical valve, a laparotomy was performed. The mycotic aneurysm was excised and the vessel was repaired by sewing an autologous venous patch at the neck of the aneurysm. Five years after the operation, the patient is doing fine, with a normal morphology and patency of the superior mesenteric artery.
Conclusion. Our case demonstrates that simultaneous valve surgery and repair of a superior mesenteric artery mycotic aneurysm by sewing a vein patch in the neck of the artery is a viable treatment option.
References
Baddour LM, Wilson WR, Bayer AS, et al. 2005. Infective endocarditis: diagnosis, antimicrobial therapy, and management of complications: a statement for healthcare professionals from the Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease, Council on Cardiovascular Disease in the Young, and the Councils on Clinical Cardiology, Stroke, and Cardiovascular Surgery and Anesthesia, American Heart Association: endorsed by the Infectious Diseases Society of America. Circulation 14:394-434.nCantisani V, Carbone I, Marcelli G, Venditti F, Bezzi M. 2000. A septic embolism and mycotic pseudoaneurysm of the superior mesenteric artery in a patient with enterococcal endocarditis. Their diagnosis by computed tomography and magnetic resonance angiography. Radiol Med (Torino) 99:285-7.nCassada DC, Stevens SL, Schuchmann GS, Freeman MB, Goldman MH. 1998. Mesenteric pseudoaneurysm resulting from septic embolism. Ann Vasc Surg 12:597-600.nCharlier P, Cohen A, Eiferman C, Reizine D, Juliard JM, Merland JJ. 1988. Selective embolization of mycotic aneurysm of the branches of the abdominal aorta. Arch Mal Coeur Vaiss 81:1269-74.nChaussende C, Laurent C, Masson B. 2001. Infected aneurysm of the superior mesenteric artery. J Chir (Paris) 138:40.nChu PH SH, Lim KE, Chu JJ. 2005. Mycotic aneurysm of the superior mesenteric artery in a young woman. Int J Clin Pract 59:614-6.nDeBakey ME, Cooley DA. 1953. Successful resection of mycotic aneurysm of superior mesenteric artery; case report and review of literature. Am Surg 19:202-12.nErbay AR, Turhan H, Dogan M, Erbasi S, Cagli K, Sabah I. 2004. Bru-cella endocarditis complicated with a mycotic aneurysm of the superior mesenteric artery; a case report. Int J Cardiol 93:317-9.nFriedman SG, Pogo GJ, Moccio CG. 1987. Mycotic aneurysm of the superior mesenteric artery. J Vase Surg 6:87-90.nHuang YK, Tseng CN, Hsieh HC, Ko PJ. 2005. Aortic valve endocarditis presents as pseudoaneurysm of the superior mesenteric artery. Int J Clin Pract Suppl 147:6-8.nJavid PJ, Belkin M, Chew DK. 2005. Mycotic aneurysm of the superior mesenteric artery: a delayed complication from a neglected septic embolus-a case report. Vase Endovascular Surg 39:113-6.nKozower BD, Windels MH, Gallagher RC. 2001. A complicated case of acute bacterial endocarditis. Conn Med 65:391-3.nMansur AJ, Grinberg M, Leao PP, Chung CV, Stolf NA, Pileggi F. 1986. Extracranial mycotic aneurysms in infective endocarditis. Clin Cardiol 9:65-72.nOhmi M, Kikuchi Y, Ito A, Ouchi M. 1990. Superior mesenteric artery aneurysm secondary to infectious endocarditis. J Cardiovasc Surg (Torino) 31:115-7.nSchmidt F, Dinkel HP. 2002. Development of mycotic aneurysms of the superior mesenteric artery after septic embolism [in German]. Radiologe 42:564-7.nSilver SE. 1999. Ruptured mycotic aneurysm of the superior mesenteric artery that was due to cardiobacterium endocarditis. Clin Infect Dis 29:1573-4.nStaat P MI, Rabatel F, Duperret S, et al. 1996. Selective embolization of ruptured mycotic aneurysm of the duodeno-pancreatic arcade disclosing infectious endocarditis. Arch Mal Coeur Vaiss 89:1431-5.nVolpe JR, Autrel D, Barral V, Brunelle F, Lallemand D. 1987. Infectious aneurysm of the superior mesenteric artery in a 14-year-old child. J Radiol 68:471-3.nWerner K, Tarasoutchi F, Lunardi W, et al. 1991. Mycotic aneurysm of the celiac trunk and superior mesenteric artery in a case of infective endocarditis. J Cardiovasc Surg (Torino) 32:380-3.n
