Mycotic Aneurysm in Recoarctation of the Aorta

Abstract

We report the case of an 8 year old boy with a post-recoarctation mycotic aneurysm demonstrated by angiography 11 months after an episode of fever and peripheral embolism successfully treated as an endocarditis. At reoperation a Gott shunt between the ascending and descending aorta was used, the recoarcted segment and aneurysm were resected and replaced by a microporous synthetic graft. Post-operatively, he developed fever associated with a pericardial friction rub. He was treated with antibiotics and became asymptomatic before discharge. Nine days later, he arrived dead in the emergency room following cardiac tamponade secondary to the rupture of false aneurysms originating at the sites of canulation for the temporary shunt. Although no infectious agent was found in cultures done post-operatively it is thought that the false aneurysms were of infectious origin. This is the first postrecoarctation mycotic aneurysm reported in the literature. The etiology, clinical evolution and treatment of post-coarctation mycotic aneurysm are reviewed. Because of the high risk of rupture and peripheral embolism in these cases, antibiotherapy and prompt surgical treat ment are indicated.