[99mTc]Tc-HMPAO-WBC SPECT/CT detection and treatment control of infection of the thoracic aortic prosthesis and paraprosthetic area caused by Morganella morganii after frozen elephant trunk surgery

Vascular grafts and endografts infection (VGEI) are considered rare but the most difficult in cardiovascular surgery. Treatment requires complete replacement of the prosthesis. However, in situations where this is technically impossible, the patient is required to take long-term (sometimes-lifelong) antibiotic therapy. Diagnosis and monitoring of treatment success requires the use of clinical data, imaging techniques, and microbiologic tests. One method for specific imaging of septic inflammation is SPECT/CT with [99mTc]Tc-HMPAO-WBC. According to EANM and ESVS guidelines, [99mTc]Tc-HMPAO-WBC SPECT/CT results definitively confirm or reject the infection. However, the control of treatment efficacy is undiscussed. This report describes a case of severe infection of the prosthesis and paraprosthetic space by Morganella morganii one year after frozen elephant trunk (FET) surgery. We applied a multidisciplinary approach to patient management and monitoring of treatment success in particular using [99mTc]Tc-HMPAO-WBC SPECT/CT.

[99mTc]Tc-HMPAO-WBC SPECT/CT detection and treatment control of infection of the thoracic aortic prosthesis and paraprosthetic area caused by Morganella morganii after frozen elephant trunk surgery Keywords:

Vascular graft/endograft infection , Frozen elephant trunk , SPECT/CT , [99mTc]Tc-HMPAO-WBC , Morganella morganii