[Dehiscence of a composite aortic graft (Bono and Bentall technique) secondary to Acinetobacter endocarditis]

Acinetobacter sp. are gram-negative bacteria and usually resistant to multiple antibiotics. They are a customary cause of nosocomial infections, but are uncommon etiologic agents of endocarditis. We present a case of endocarditis caused by Acinetobacter iwoffi in a composite aortic graft with a St. Jude prosthetic valve, using the Bono and Bentall procedure, complicated with multiple graft dehiscenses causing first a peritube pseudoaneurysm and finally severe paraprosthetic valve regurgitation to the left ventricle which required emergency surgery.

[Coronary dissection following coronary radiography]

We present 4 cases of dissection of the coronary arteries during coronary radiography, which required emergency surgery. The right coronary was dissected in 2 cases and the left coronary in the remaining cases. Coronary artery bypass was carried out using saphenous vein. Although one patient suffered myocardial infarction, all patients had successful recovery and evolution.

Post-coronariography dissection of the right coronary artery

The case of a patient undergoing an emergency aortocoronary bypass to the right coronary artery after its acute dissection at coronariography is presented. Surgery was carried out two hours after the incident. After successful recovery and postoperative study, it was concluded that the main technical problem posed by this operation which was whether or not to ligate proximally the right coronary was satisfactorily solved by the initial decision not to ligate it.