Mycotic Abdominal Aortic Aneurysm Secondary to Septic Embolism of a Thoracic Aorta Graft Infection

Amil, Carla Lorena Blanco; Rey, Jorge; Arquillo, I. López; Pérez-Rodríguez, M. Teresa; Sá, J.M. Encisa de

doi:10.1016/j.avsg.2015.11.029

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“…The choice of the ideal conduit is still controversial [ 12 ]. To reduce the risk of reinfection, rifampicin-impregnated grafts or cryopreserved arterial homografts can be used instead of prosthetic grafts.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Open Repair of Mycotic Aortic Aneurysms with In Situ Replacement

Kim

Joo

2017

Korean J Thorac Cardiovasc Surg

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BackgroundMycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy.MethodsFrom 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue. We recorded the clinical findings, anatomic location of the aneurysm, bacteriology results, antibiotic therapy, morbidity, and mortality for these cases.ResultsThe median age was 62±7.2 years (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was 44.5±4.9 mm. The mean time from onset of illness to surgery was 14.5±2.4 days. Aortic continuity was restored in situ with a Dacron prosthesis (79%), homograft (16%), or Gore-Tex graft (5%). Soft-tissue coverage of the prosthesis was performed in 8 patients. The mean follow-up time was 43.2±11.7 months. The early mortality rate was 10.5%, and the 5-year survival rate was 74.9%±11.5%.ConclusionThis study showed acceptable early and midterm outcomes of open repair of mycotic aneurysms. We emphasize that aggressive intraoperative debridement with soft-tissue coverage results in a high rate of success in these high-risk patients.

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Section: Discussionmentioning

confidence: 99%