JACC. Case reports · 2026
Perioperative and Surgical Management of a Ruptured Mycotic Coronary Artery Aneurysm Secondary to MRSA.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Goodman Ariana, Amirjamshidi Hossein, Mo Julia, Simon Bartholomew, Fitch Jeffery, Krishnamoorthy Vijay, Hisamoto Kazuhiro
Аннотация
BACKGROUND: Mycotic coronary artery aneurysms are rare, life-threatening complications of systemic infection that present challenges regarding surgical approach and myocardial revascularization.
CASE SUMMARY: This report details the successful management of a 56-year-old man with methicillin-resistant Staphylococcus aureus bacteremia who presented with a ruptured right coronary artery mycotic aneurysm and purulent pericardial effusion.
DISCUSSION: Intraoperative management necessitated aggressive debridement of infected tissue, careful assessment for distal bypass targets in the setting of severe inflammation, and prolonged postoperative antibiotic therapy. The patient had a decrease in left ventricular ejection fraction with wall motion abnormalities associated with a sacrificed territory because of unsuitable targets for bypass. He has been followed for 1 year and is doing well without the need for further intervention.
TAKE-HOME MESSAGE: Ultimately, treatment of these high-risk lesions relies on a multidisciplinary approach prioritizing complete resection of infected pathology, appropriate revascularization, and long-term medical management to prevent recurrent serious complications.
CASE SUMMARY: This report details the successful management of a 56-year-old man with methicillin-resistant Staphylococcus aureus bacteremia who presented with a ruptured right coronary artery mycotic aneurysm and purulent pericardial effusion.
DISCUSSION: Intraoperative management necessitated aggressive debridement of infected tissue, careful assessment for distal bypass targets in the setting of severe inflammation, and prolonged postoperative antibiotic therapy. The patient had a decrease in left ventricular ejection fraction with wall motion abnormalities associated with a sacrificed territory because of unsuitable targets for bypass. He has been followed for 1 year and is doing well without the need for further intervention.
TAKE-HOME MESSAGE: Ultimately, treatment of these high-risk lesions relies on a multidisciplinary approach prioritizing complete resection of infected pathology, appropriate revascularization, and long-term medical management to prevent recurrent serious complications.