Mycotic Aneurysm of the Right Coronary Artery

Omoto, Tadashi; Saito, Kiyoshi; Kashima, Toshitaka; Kume, Masato; Hosaka, Shigeru; Kimura, Sosuke

doi:10.1177/021849230601400413

Cited by 10 publications

(15 citation statements)

References 11 publications

(11 reference statements)

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“…Surgical resection of mycotic coronary artery aneurysms is associated with lower mortality rates than conservative management. There is no clear answer regarding the timing of surgery; however, the literature suggests urgent surgery to avoid rupture of the aneurysm 14. This patient underwent surgery 3 days after the diagnosis.…”

Section: Discussionmentioning

confidence: 94%

Resection of a large mycotic aneurysm of the left anterior descending coronary artery

2019

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A 50-year-old Indigenous woman, on home haemodialysis, was found to have a large mycotic aneurysm of the proximal left anterior descending coronary artery at the site of a previous drug-eluting stent. Blood cultures grew methicillin-sensitive Staphylococcus aureus bacteraemia. She underwent a complex operation involving resection of the mycotic aneurysm, removal of the stent and a coronary artery bypass graft to the distal left anterior descending (LAD) coronary artery using the left internal mammary artery. She had a complicated intensive care unit admission with pericardial tamponade on day 1 postoperatively requiring reopening and removal of clot and type 1 respiratory failure requiring reintubation on day 10 postoperatively. Once extubated, she developed prolonged hyperactive delirium and a significant decline in mobility. Over the course of a 6-week hospital admission, she received extensive multidisciplinary care and was discharged for rehabilitation to a peripheral hospital. She was discharged home after rehabilitation with ongoing follow-up with infectious diseases.

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Section: Discussionmentioning

confidence: 94%

Resection of a large mycotic aneurysm of the left anterior descending coronary artery

2019

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“…4 Although the timing of surgery is not well defined, the literature supports urgent aneurysmal resection and CABG to avoid the risks of aneurysmal rupture. 9 This case highlights the difficulty in the diagnosis of mycotic aneurysms of the coronary arteries. Although the LMCA aneurysm was discovered incidentally, the patient did have several NSTEMIs during his initial inpatient admission.…”

Section: Commentmentioning

confidence: 88%

“…Given the inherent risk of enlargement of the aneurysm and subsequent rupture, the treatment modality of choice for mycotic aneurysms of the coronary arteries has been surgery since the first successful procedure in 1970 . Although the timing of surgery is not well defined, the literature supports urgent aneurysmal resection and CABG to avoid the risks of aneurysmal rupture …”

Section: Commentmentioning

confidence: 99%

Mycotic Pseudoaneurysms of the Coronary Arteries

et al. 2015

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“…They lead to significant morbidity and mortality due to complications such as acute myocardial infarction, myocarditis, myocardial abscesses, and even sudden death [7]. These reports (largely clinical) do not mention the concomitant occurrence of arteritis in these circumstances, except when the septic embolism results in aneurysm formation [8]. Among the 10 reported cases, 6 had infective endocarditis, which had understandably affected the left-sided valves or patch in 4 patients.…”

Section: Discussionmentioning

confidence: 99%