Organ Protection for Radical Debridement to Prevent Recurrence of Infection after Zone 1 Thoracic Endovascular Aortic Aneurysm Repair: A Case Report

Abstract

We present the case of a 73-year-old man with stent graft infection, who had undergone thoracic endovascular aortic aneurysm repair with a supra-aortic bypass from the right axillary to the left common carotid and axillary arteries. The procedure included total stent graft removal, radical debridement, and in situ graft replacement via left anterolateral thoracotomy. Cerebral perfusion from the left axillary artery and cardioplegia using an occlusion balloon with moderate hypothermia were performed to reinforce organ protection. Staged omentopexy was performed the next day after initial replacement with non-contaminated instruments. The postoperative course was uneventful. No recurrence of infection has been found for 3 years.