Implantation of a composite bifurcated cryopreserved aorto-iliac-femoral homograft in a patient with Candida albicans endocarditis
Abad, C.; Maynar, M.; Ponce, G.; Chau, O.; Cárdenes, M.A.; Jiménez, P.; Betancor, P.
Journal of Cardiovascular Surgery 41(2): 317-319
2000
ISSN/ISBN: 0021-9509 PMID: 10901544 Document Number: 514330
A case is reported in a 35-year-old woman from Spain , who developed C. albicans aortic valve endocarditis complicated with embolization of infected vegetations in the distal abdominal aorta. She underwent successful staged aortic valve replacement followed by transaortic and transfemoral thrombectomy, and received 6 months of amphotericin B therapy. One month later an arteriogram disclosed partial occlusion of the left iliac artery, bilateral aneurysmal degeneration of both iliac arteries and right iliac artery-right iliac vein fistula. She underwent surgery again, performing re-laparotomy and re-exploration. A composite bifurcated cryopreserved homograft was implanted end-to-side between the infrarenal abdominal aorta, right external iliac artery and left common femoral artery. The right iliac artery-iliac vein fistula was obliterated with suture. The patient had an uneventful recovery but a relapsing arterio-venous fistula was diagnosed by arteriography. Three months later she underwent percutaneous transluminal closure of the reopened fistula. At follow-up 17 months after the implantation of the homograft, the patient was symptom-free, on antifungal agents and with arteriographic and clinical evidence of a well-functioning arterial homograft.