Successful management of mycotic visceral aneurysms in a LVAD patient and navigating LVAD postoperative challenges

IF 0.7 Q4 SURGERY Journal of Vascular Surgery Cases Innovations and Techniques Pub Date : 2025-04-01 Epub Date: 2024-12-24 DOI:10.1016/j.jvscit.2024.101715
Kendall Wermine MD , Salman Gohar MD , Rusty Milhoan MD , Bryan Youree MD , Vivek Ramarathnam MD , Mohammad Alqaim MD
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Abstract

This report presents a unique case of concurrent mycotic aneurysms in a 64-year-old male left ventricular assist device (LVAD) recipient. Initially admitted with odontogenic maxillary fungal sinusitis and fungemia, he later presented to our clinic with significant weight loss, fatigue, and LVAD complications. Imaging revealed a large complex mid-superior mesenteric artery aneurysm with multiple associated jejunal branches and a ruptured splenic aneurysm. Although these aneurysms were successfully managed, it is important to note the challenges in postoperative care, including anticoagulation-related complications such as post-splenectomy hematoma and intracranial bleeding. This case highlights the delicate balance between therapeutic interventions and managing LVAD-related complexities.

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LVAD患者真菌性内脏动脉瘤的成功治疗和LVAD术后的挑战。
本文报告一例64岁男性左心室辅助装置(LVAD)受者并发真菌性动脉瘤。他最初因牙源性上颌真菌性鼻窦炎和真菌血症入院,后来因明显的体重减轻、疲劳和LVAD并发症来到我们诊所。影像显示一个大而复杂的肠系膜中上动脉动脉瘤并伴有多个空肠分支和脾动脉瘤破裂。虽然这些动脉瘤得到了成功的治疗,但术后护理的挑战是重要的,包括抗凝相关的并发症,如脾切除术后血肿和颅内出血。本病例强调了治疗干预和处理lvad相关复杂性之间的微妙平衡。
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来源期刊
CiteScore
1.00
自引率
14.30%
发文量
219
审稿时长
29 weeks
期刊介绍: Journal of Vascular Surgery Cases and Innovative Techniques is a surgical journal dedicated to publishing peer review high quality case reports, vascular images and innovative techniques related to all aspects of arterial, venous, and lymphatic diseases and disorders, including vascular trauma, malformations, wound care and the placement and maintenance of arterio-venous dialysis accesses with an emphasis on the practicing clinician. The Journal seeks to provide novel and timely information to vascular surgeons, interventionalists, phlebologists, wound care specialists, and allied health professionals involved with the management of patients with the entire spectrum of vascular disorders.
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