Mycotic aneurysm of the ascending aorta after coronary revascularization.

A mycotic aneurysm developed at the aortic cannulation site after coronary revascularization and subsequent mediastinitis. Treatment required hypothermic circulatory arrest and patch repair. Review of the literature revealed 40 cases, 11 after various open heart procedures and 10 after either heart or heart and lung transplantation. Postoperative mediastinitis was present in 12. Nine of 12 patients operated on electively survived, versus 4 of 10 who had rupture. Mycotic aneurysms of the ascending aorta are rare but do occur after heart operations, especially in transplant patients.