Abstract
An infected aortic aneurysm after thoracic endovascular aneurysm repair is a dire, life-threatening condition. We report the case of an infected thoracic aortic aneurysm successfully treated by wrapping the pedicled latissimus dorsi muscle flap. The patient was a massively obese 62-year-old man who had been undergoing maintenance hemodialysis and had undergone thoracic endovascular aneurysm repair 8 months previously. He became febrile and was diagnosed with an infected thoracic aortic aneurysm and mediastinitis. After the mediastinitis was treated with a vacuum-assisted closure device, an operation was performed for the infected thoracic aortic aneurysm. Fistulous communication between the aorta and the pulmonary parenchyma was found. There was purulent collection inside the aneurysm, and aortotomy and left upper lobectomy (LUL) were performed. The stent graft was wrapped with the pedicled latissimus dorsi (PLD) muscle flap. The mediastinal wound was closed by a rectus abdominis muscle flap. Postoperative infection remained well controlled even 5 months after the operation, and the patient was able to live a comfortable life in the hospital. The PLD muscle flap is considered to be reliable and useful.
