Abstract
A 42-year-old man with Marfan syndrome who had undergone ascending and aortic root replacement with a composite graft for acute type A aortic dissection 3 months prior was admitted to our department. He underwent an abdominal aorta replacement for an abdominal aortic aneurysm and suffered from a high grade fever and right upper limb paralysis due to a cerebral mycotic aneurysm rupture. Chest computed tomography (CT) showed a pseudoaneurysm in the aortic root, and blood culture revealed MSSA-positive cultures. Positron-emission tomography-CT showed positive signs only on the aortic root and ascending vascular prosthesis. Re-aortic root replacement with a rifampicin-soaked vascular prosthesis was performed after antibiotic therapy was administered for 2 weeks following the cerebral hemorrhage. However, dehiscence of the suture line on the aortic annulus of the non-coronary cusp was observed. Therefore, 2 days later, an omentopexy around the aortic root was performed. Antibiotics were administered intravenously for 6 weeks postoperatively, and the right upper limb paralysis improved with rehabilitation. The appropriate therapeutic strategy is important for vascular graft infections with cerebral complications. We herein report the successful outcome of multidisciplinary treatment.
