Methodist Journal

IN THIS ISSUE

Adult Congenital Heart Update

Vol 15, Issue 2 (2019)


FEATURED GUEST EDITOR

ISSUE INTRO

The Growing Number of Adults Surviving with Congenital Heart Disease

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RECOGNITIONS

Drs. MacGillivray and Lin Take the Lead in Adult Congenital Heart Disease

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REVIEW ARTICLES See More

Advanced Cardiac Imaging for Complex Adult Congenital Heart Diseases

149 Fontan Conversions

Anomalous Aortic Origin of a Coronary Artery

Pulmonary Valve Replacement for Tetralogy of Fallot

Management of the Adult with Arterial Switch

Ebstein’s Anomaly

Heart Transplantation in Adults with Congenital Heart Disease

Cholesterol: Can’t Live With It, Can’t Live Without It

CASE REPORTS See More

Simultaneous Transfemoral Mitral and Tricuspid Valve in Ring Implantation: First Case Report with Edwards Sapien 3 Valve

Uneventful Follow-Up 2 Years after Endovascular Treatment of a High Flow Iatrogenic Aortocaval Fistula Causing Pulmonary Hypertension and Right Heart Failure

Device-Related Thrombus: A Reason for Concern?

Retained Coronary Balloon Requiring Emergent Open Surgical Retrieval: An Uncommon Complication Requiring Individualized Management Strategies

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER See More

Do I Look Fat in This? Multimodality Imaging Findings of a Cardiac Lipoma

CLINICAL PERSPECTIVES See More

POINTS TO REMEMBER

The Kidney in Congenital Cyanotic Heart Disease

EXCERPTA

Talking Statins with Antonio Gotto

POINTS TO REMEMBER

Lipids and Renal Disease

EXCERPTA

Addressing the Feedback Loop Between Depression, Diabetes, and Cardiovascular Disease

EDITORIALS

Letter to the Editor in Response to “Cardiac Autonomic Neuropathy in Diabetes Mellitus”

Vol 14, Issue 3 (2018)

Article Full Text

MUSEUM OF HMH MULTIMODALITY IMAGING CENTER

Incision and Drainage of a Forgotten Vascular Graft

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Article Citation:

DaSilva-DeAbreu A, Hsi B. Incision and Drainage of a Forgotten Vascular Graft. Methodist DeBakey Cardiovasc J. 2018;14(3):236.



Keywords
femoral-popliteal bypass , vascular graft

A 64-year-old woman with type-2 diabetes mellitus, peripheral artery disease with bilateral below-knee amputation, and recurrent soft tissue infections on her right thigh presented with a 5-day history of an abscess on the posterior side of her right thigh (Panel A). She was prescribed oral clindamycin followed by incision and drainage the next day, which revealed a vascular graft that protruded at about 20 cm from the draining site without any sign of bleeding (Panel B; in both panels, the patient is lying down with the right knee elevated).

She had undergone a femoral-popliteal bypass 2 years prior to presentation followed by ilio-peroneal bypass and excision of the former. She had right below-knee amputation 2 months later but continued having recurrent soft tissue infections on the right thigh associated with poorly controlled diabetes and a hemoglobin A1c of up to 18.5.

The patient was admitted to the hospital, where she received broad-spectrum antibiotics and underwent surgical exploration of the right groin. The femoral artery was located without evidence of graft anastomosis. The graft was retrieved from the superficial free end on the posterior aspect of the thigh. The wound tract was irrigated, obtaining notable purulent drainage. Wound cultures grew Pseudomonas aeruginosa, for which she received meropenem. She progressed uneventfully and was discharged home.

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