Successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium

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• 作者：Yosuke Takahashi MD (1)
  Yasuyuki Sasaki MD (1)
  Toshihiko Shibata MD (1)
  Yasuyuki Bito MD (1)
  Shigefumi Suehiro MD (1)
  
• 关键词：mycotic aneurysm ; Staphylococcus aureus septicemia
• 刊名：General Thoracic and Cardiovascular Surgery
• 出版年：2005
• 出版时间：December 2005
• 年：2005
• 卷：53
• 期：12
• 页码：661-664
• 全文大小：500KB
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• 作者单位：Yosuke Takahashi MD (1)
  Yasuyuki Sasaki MD (1)
  Toshihiko Shibata MD (1)
  Yasuyuki Bito MD (1)
  Shigefumi Suehiro MD (1)
  
  1. Department of Cardiovascular Surgery, Osaka City University Medical School, 1-4-3 Asahi-machi, Abeno-ku, 545-8585, Osaka, Japan
  

文摘

We reported successful surgical treatment of a mycotic right coronary artery aneurysm complicated by a fistula to the right atrium in a 60-year-old man admitted to hospital because of acute worsening of renal function and erythroderma. After admission, he suffered from methicillin-resistantStaphylococcus aureus septicemia. Despite administration of vancomycin hydrochloride, a low-grade fever persisted. Subacute cardiac tamponade occurred three months after admission, and acute inferior wall myocardial infarction occurred two weeks after pericardial drainage. An emergent coronary angiography demonstrated a large saccular aneurysm of the right coronary artery forming a fistula to the right atrium and obstruction of the distal right coronary artery. We emergently resected the aneurysm including the right atrial wall and repaired the defect in the right atrium. Pathological examination of the aneurysmal wall revealed its mycotic nature; the postoperative course was uneventful. (Jpn J Thorac Cardiovasc Surg 2005; 53: 661-64)