Hybrid approach to management for a patient with culture negative infective endocarditis with profunda femoris mycotic pseudoaneurysm: A case report and review of the literature.

Autor: Alshair FM; Division of Cardiac Surgery, Department of Surgery King Abdulaziz University Hospital Jeddah Saudi Arabia., Baghaffar AH; Division of Cardiac Surgery, Department of Surgery King Abdulaziz University Hospital Jeddah Saudi Arabia.; Faculty of Medicine King Abdulaziz University Jeddah Saudi Arabia., Fatani MA; Division of Cardiac Surgery, Department of Surgery King Abdulaziz University Hospital Jeddah Saudi Arabia.; Faculty of Medicine King Abdulaziz University Jeddah Saudi Arabia., Jamjoom RA; Faculty of Medicine King Abdulaziz University Jeddah Saudi Arabia.; Division of Vascular Surgery, Department of Surgery King Abdulaziz University Hospital Jeddah Saudi Arabia.
Jazyk: angličtina
Zdroj: Clinical case reports [Clin Case Rep] 2024 Mar 14; Vol. 12 (3), pp. e8664. Date of Electronic Publication: 2024 Mar 14 (Print Publication: 2024).
DOI: 10.1002/ccr3.8664
Abstrakt: Mycotic pseudoaneurysms can be a serious and life threatening complication of left sided infective endocarditis. They most commonly affect the major axial vessels. Profunda femoris artery (PFA) aneurysms are rare and present in only 0.5% of all peripheral aneurysms, regardless of the underlying etiology. We present a case of a patient who underwent mitral valve repair for severe mitral regurgitation secondary to culture negative IE which was complicated by multiple mycotic pseudoaneurysm. The PFA pseudoaneurysm which was affected and was complicated with a large hematoma compressing the femoral nerve. This was managed by a staged hybrid approach. Endovascular stenting was performed first to seal the pseudoaneurysm and facilitate open surgical repair using a reversed interposition saphenous vein graft. To the best of our knowledge, this is the first reported case of a PFA mycotic aneurysm (MA) being managed by a hybrid approach using endo-vascular and open surgical repair. MAs and pseudoaneurysms are complex and life threatening conditions requiring meticulous planning for optimal management. Endovascular stenting can be considered as an alternative to surgical management in certain cases or as a bridge to definitive open surgical repair depending on anatomical location and associated complications.
Competing Interests: The authors declare that there are no conflicts or competing interests.
(© 2024 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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