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Title: Intraoperative transoesophageal echocardiographic diagnosis and successful management of mycotic aortitis and pseudoaneurysm.
Austin Authors: Tan, Chong Oon;Weinberg, Laurence ;Pillai, Parameswan ;Fernandes, Jon
Affiliation: Department of Anaesthesia, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 22-Nov-2013
Publication information: BMJ Case Reports 2013; 2013: bcr-2013-200675
Abstract: A 38-year-old intravenous drug using man was scheduled for urgent pericardial window surgery to treat pericardial effusion and tamponade. Transoesophageal echocardiography (TOE) during the procedure revealed a minor residual effusion and an atypical heterogenous thickened appearance of the pericardium and adjoining aortic root. Interrogation of the aortic valve with a 'panning' manoeuvre from the mid-oesophageal aortic valve short axis view showed a small hypoechoic lesion between the right and non-coronary cusp at the level of the sinus of Valsalva. Postoperative high-resolution contrast CT confirmed the anaesthesia TOE findings of a small pseudoaneurysm. The decision was then made to proceed to formal aortic root replacement after 5 days of directed antibiotic therapy and evidence of an increase in aneurysm size to 2.7 cm on repeat CT angiogram. The patient made a good postoperative recovery and was eventually discharged from the hospital 3 weeks after his second operation.
Gov't Doc #: 24273009
DOI: 10.1136/bcr-2013-200675
Journal: BMJ Case Reports
Type: Journal Article
Subjects: Adult
Aorta, Thoracic
Echocardiography, Transesophageal
Follow-Up Studies
Heart Valve Prosthesis Implantation.methods
Intraoperative Care.methods
Risk Assessment
Severity of Illness Index
Tomography, X-Ray Computed.methods
Treatment Outcome
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