Treatment of mycotic infection of thoracic aortic stent-graft

The authors describe a rare but extremely severe complication of endovascular treatment of descending thoracic aortic aneurysm (fungal infection of stent-graft). Despite prompt diagnosis and antibacterial/antifungal therapy, infection progressed with subsequent false aneurysms within stent graft attachment zones accompanied by episodes of hemoptysis. Surgical intervention included extraanatomical ascending-descending bypass, total aortic arch debranching, removal of infected stent graft, debridement and omentoplasty. Thanks to timely surgical intervention and comprehensive treatment, clinical status stabilized. Further follow-up demonstrated satisfactory results (no signs of reinfection, competent vascular anastomoses and favorable clinical status). This case highlights the role of timely diagnosis of infectious complications of stent grafts, as well as the need for individualized approaches including extraanatomical bypass grafting and omentoplasty.