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Successful drainage of periaortic graft abscess and transcatheter aortic valve replacement in the same setting - a hybrid approach.
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  • Ahmed S. Nasser,
  • Osama Elkhateeb,
  • Keir Stewart,
  • Hashem Aliter
Ahmed S. Nasser
Dalhousie University Faculty of Medicine

Corresponding Author:[email protected]

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Osama Elkhateeb
Dalhousie University Department of Medicine
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Keir Stewart
Dalhousie University Division of Cardiac Surgery
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Hashem Aliter
Dalhousie University Division of Cardiac Surgery
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81-year-old man with a history of Bio-Bentall surgery presented to the emergency department with fever, chills and back pain. Initial physical examination was inconclusive apart from sudden onset of delirium, and investigation showed elevated WBCs, anemia, and neutrophilia. Further studies revealed gram-positive cocci on the initial blood culture, which was then confirmed to be MSSA bacteremia. Subsequently, a TEE showed a peri-aortic abscess, Moderate AR and severe AS with no evidence of endocarditis. Antibiotics were started and urgent abscess drainage was planned. In a hybrid operative setting, a multidisciplinary team of cardiology, and cardiac surgery managed the periaortic graft abscess drainage through a median sternotomy and TAVR. Post-operatively, the complications included bradycardia, and RHF. Six-week course of IV Rifampin, Probenecid and Cefazolin was initiated, and patient was to remain on lifelong Cefadroxil.
16 Jun 2022Submitted to Journal of Cardiac Surgery
16 Jun 2022Submission Checks Completed
16 Jun 2022Assigned to Editor
04 Jul 2022Reviewer(s) Assigned
07 Aug 2022Review(s) Completed, Editorial Evaluation Pending
29 Aug 2022Editorial Decision: Accept
Nov 2022Published in Journal of Cardiac Surgery volume 37 issue 11 on pages 3904-3907. 10.1111/jocs.16949