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Ann Thorac Surg 1998;66:1818-1819
© 1998 The Society of Thoracic Surgeons

Case Reports

Homograft failure in mycotic aortic aneurysm caused by streptococcus pneumoniae

Pascal A. Berdat, MDa, Raffaele Malinverni, MDb, Beat Kipfer, MDa, Thierry P. Carrel, MDa

a Clinic for Thoracic and Cardiovascular Surgery, University Hospital of Berne (Inselspital), Berne, Switzerland
b Medical Policlinic, University Hospital of Berne (Inselspital), Berne, Switzerland

Accepted for publication May 8, 1998.

Address reprint requests to Dr Berdat, Clinic for Thoracic and Cardiovascular Surgery, Inselspital, 3010 Berne, Switzerland

Treatment of a rare Streptococcus pneumoniae mycotic aneurysm by homograft replacement failed in a 59-year-old patient because of persistent lobar pneumonia. Despite reoperation with replacement of the infected homograft by a fresh one, he finally died of septicemia. This case illustrates that homograft tissue may be infected per continuum and that extensive debridement of periaortic tissue—including major lung resection—and the use of muscle flaps may be necessary in certain circumstances.




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