Gastric Malignancy Causing E. Coli Infection of a Frozen Elephant Trunk Stent Graft and the use of Transthoracic Composite muscle Flaps for Graft Salvage

Fong Hui Chai,Chao Victor Tar Toong,Tan Bien-Keem,Leung Jason Hongting

doi:10.36959/582/434

Fong Hui Chai, Chao Victor Tar Toong + Show 2 more

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https://doi.org/10.36959/582/434

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Abstract

We describe an unusual case of gastric malignancy presenting as Escherichia Coli infection of a frozen elephant trunk stent graft, with associated empyema that was successfully salvaged with decortication and aneurysm resection. Intrathoracic transposition of a combined latissimus dorsi / serratus anterior flap was used for salvage of the stent graft.

Highlights

Transthoracic muscle transposition is a useful technique for the treatment of intrathoracic air leak or empyema [1]
We describe an unusual case of gastric malignancy presenting as Escherichia Coli infection of a frozen elephant trunk stent graft, with associated empyema that was successfully salvaged with decortication and aneurysm resection
The donor site was closed with progressive tension sutures over suction drainage. 2 weeks later, an additional stent graft was successfully deployed via the transapical approach to extend the existing frozen elephant trunk down the descending thoracic aorta in order to provide a margin of safety with regards to the distal seal zone

Summary

Introduction

Transthoracic muscle transposition is a useful technique for the treatment of intrathoracic air leak or empyema [1]. We describe an unusual case of gastric malignancy presenting as Escherichia Coli infection of a frozen elephant trunk stent graft, with associated empyema that was successfully salvaged with decortication and aneurysm resection. Intrathoracic transposition of a combined latissimus dorsi / serratus anterior flap was used for salvage of the stent graft.

Results

Conclusion