Mycotic Aortic Pseudoaneurysm Following ECMO Cannulation

IntroductionMycotic aortic pseudoaneurysms (MAP) are a rare but often fatal complication of thoracic surgery. Recently, our institution has transitioned to performing all lung transplants on venous-arterial extracorporeal membrane oxygenation (VA-ECMO) support when possible. Reinforcement cannulation sites with pledgeted sutures is necessary control bleeding; however, pledgets could also represent an iatrogenic risk for infection. Here we present case MAP at the site in transplant recipient (LTR).Case ReportWe 56-year-old female who underwent bilateral scleroderma-related interstitial disease. Two months following transplant, she was admitted methicillin-resistant staphylococcus aureus bacteremia. Initial echocardiogram inconclusive endocarditis and thus treated IV vancomycin six weeks clinical improvement. Unfortunately, two later presented recurrent imaging revealed evidence ascending formation, confirmed by positron emission tomography (Figure 1). She surgical repair identification palpable pathology consistent acute organizing inflammation microabscess formation. Despite aggressive medical management, patient suffered catastrophic embolic stroke.SummaryWhile ECMO many potential benefits, it not without risk. Closure immunosuppressed patients may lead development infected can have devastating consequences. To knowledge this first pledget LTR. Mycotic (LTR). We stroke. While