Perioperative and Surgical Management of a Ruptured Mycotic Coronary Artery Aneurysm Secondary to MRSA.

Authors

Ariana Goodman, Hossein Amirjamshidi, Julia Mo, Bartholomew Simon, Jeffery Fitch, Vijay Krishnamoorthy, Kazuhiro Hisamoto

Published in

JACC. Case reports. Pages 110746. Sep 30, 2026. Epub Sep 30, 2026.

Abstract

Mycotic coronary artery aneurysms are rare, life-threatening complications of systemic infection that present challenges regarding surgical approach and myocardial revascularization.
This report details the successful management of a 56-year-old man with methicillin-resistant Staphylococcus aureus bacteremia who presented with a ruptured right coronary artery mycotic aneurysm and purulent pericardial effusion.
Intraoperative management necessitated aggressive debridement of infected tissue, careful assessment for distal bypass targets in the setting of severe inflammation, and prolonged postoperative antibiotic therapy. The patient had a decrease in left ventricular ejection fraction with wall motion abnormalities associated with a sacrificed territory because of unsuitable targets for bypass. He has been followed for 1 year and is doing well without the need for further intervention.
Ultimately, treatment of these high-risk lesions relies on a multidisciplinary approach prioritizing complete resection of infected pathology, appropriate revascularization, and long-term medical management to prevent recurrent serious complications.

PMID:
42886130
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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