Salmonella enteritidis Mycotic Aneurysm of Stented Saphenous Vein Graft to Coronary Artery

Outcome of a giant coronary artery mycotic pseudoaneurysm secondary to non-typhoidSalmonellamanaged without surgical intervention

“…Similarly, due to limited information, there are no set guidelines available for the treatment of a smaller selected population that involves giant mycotic coronary pseudoaneurysms. There are four reported cases of mycotic pseudoaneurysms greater than 5 cm, all of which were intervened with emergent surgery 4–7. Of these four cases, three survived and one patient died postoperatively 7.…”

“…Progression of the pseudoaneurysm and leakage into its surrounding tissue is noted on follow-up coronary CT angiography (figure 3). Despite mortality rate as high as 25% in the previous surgically intervened cases,4–7 conservative management may not be a viable option to consider long-term. Medical management was entertained because of the high-risk procedure associated with mass effect of the pseudoaneurysm onto the left pulmonary artery structure, and expected poor prognosis with limited life expectancy in a patient with multiple comorbidities.…”

“…Other less common causes include HIV vasculitis, mycosis and cocaine use 1. The aetiology of giant coronary artery pseudoaneurysms has largely been secondary to atherosclerotic disease3; however, rare cases of giant mycotic coronary artery pseudoaneurysms have been described 4–7. Overall, mycotic pseudoaneurysms of the coronary arteries are exceedingly rare, accounting for less than 3% of all coronary artery pseudoaneurysms 8.…”