胸部ステントグラフト内挿術後遠隔期ステントグラフト感染に対して異種心膜ロール再建を行った1例

Self-made Bovine Pericardial Roll Graft Replacement of Infected Aneurysm Following Thoracic Endovascular Aortic Repair；Report of a Case

はじめに　ステントグラフト内挿術は低侵襲であることから，近年胸部大動脈瘤に対しても広く行われるようになった．ステントグラフト感染は比較的まれではあるが重篤な合併症で，その発生率は0.05～4％1，2）と報告されている．われわれは上行弓部大動脈置換およびステントグラフト内挿術後遠隔期のステントグラフト感染に対し，ステントグラフト抜去，異種心膜ロールによる同所再建および大網被覆術を行い，良好な成績を得たので報告する．

A 72 years-old man was admitted with fever and cough. He had undergone aortic arch graft replacement with elephant trunk and endovascular stent graft for distal arch aortic aneurysm 1 year ago. Additionally, he had treated type I endoleak with an endovascular stent graft 3 month previously. Computed tomography showed soft tissue around the aneurysm and visible gas bubble within intramural thrombus, and he was diagnosed with stent graft infection. The stent graft was removed and aortic reconstruction was performed using bovine pericardial roll grafts. The grafts were covered with the greater omentum. He was discharged on the 48th postoperative day, and was alive and well 4 years after the operation.