Neoaortoiliac system buttressed with tensor fascia lata for treatment of juxtarenal mycotic aortic aneurysm

摘要

A 50-year-old man presented with abdominal pain and high-grade fever for 3 months and was diagnosed to have juxtarenal saccular abdominal aortic aneurysm and superior mesenteric artery stenosis on imaging (A). He was diabetic and a chronic smoker. Blood and urine culture specimens had grown group D Salmonella. Open repair of the mycotic aneurysm was done with a neoaortoiliac system using bilateral superficial femoral veins and autol- ogous tensor fascia lata to reinforce the proximal anastomotic line (B and C). The patient was also prescribed long-term antibiotic therapy. The postopera- tive period was uneventful except for mild lymphorrhea from bilateral thigh wounds that subsided by 1 week. He was discharged on postoperative day 11 with normal pedal pulses and preserved renal function. On 3-month follow-up, the patient is doing well and is asymptomatic. Follow-up computed tomography showed intact anastomoses with good flow through the vein graft (D/Cover).