上行大動脈人工血管内に疣贅を認めた1例

Vegetation Developed in the Artificial Graft of Ascending Aorta：Report of a Case

はじめに　人工血管感染の致死率は25～75％と，いまだに死亡率が高い疾患である1.2）．本例は重症のアトピー性皮膚炎に罹患しており，細菌の侵入門戸であったと考えられた．上行大動脈に移植された人工血管内に疣贅を認めた症例には検索した限り報告がなく，非常にまれなものと思われる．再上行弓部大動脈人工血管置換術，大網充塡術により良好な経過を認めたため，報告する．

The case was a 65-year-old woman. She underwent graft replacement of ascending aorta because she developed Stanford type A acute aortic dissection in November 2016. After six months she had a fever, so she underwent contrast-enhanced computed tomography and echocardiography at the previous hospital. An abnormal shadow was found in the artificial blood vessel, and the blood culture test was positive. The abnormal shadow was suspected to be a vegetation and was referred to our department. Vegetation was highly mobile and emergency surgery was performed considering the risk of embolism. Intraoperative findings showed that vegetation was attached to the anastomotic site of the artificial blood vessel. She was transferred to a rehabilitation hospital 57 days after the operation and is currently rehabilitating.