Abstract
We recently experienced an uncommon case of thrombosed intraluminal prosthesis, which was inserted in the ascending aorta.
A 61-year-old man with acute type I aortic dissection was treated using intraluminal prosthesis. Prulent exsudate from the median incision was persistent until sternal wire was removed. Postoperative aortography showed well functioning graft. Four months later, Y graft implantation with fenestration was applied to the infrarenal aortic lesion. During the operation his hemodynamics came to be unstable. Aortography revealed severe stenosis of intraluminal graft. Emergent thrombectomy was unsuccessful. Intraluminal graft was nearly occluded by the chronic thrombus. Candida albicans was cultured from the thrombus and granulation tissues around the graft. The thrombus was a bacterial thrombus caused by candida albicans, which might gradually grow to plug up the graft lumen. This case could not be saved because of delayed diagnosis. When we encounter a patient undergoing replacement of chest aorta followed by an infection at the excised site, a possibility of graft infection should be kept in mind usually and a careful follow-up is essential to prevent a complication being irreversible.
