Report of two in situ reconstructions with a saphenous spiral vein graft of Coxiella burnetii-infected aneurysms of the abdominal aorta

Aerts, Priscilla D.M.; Zitteren, Moniek van; Kasteren, M.E.E. van; Buiting, A. G. M.; Heyligers, Jan M.M.; Vriens, Patrick W.

doi:10.1016/j.jvs.2012.08.042

Cited by 19 publications

(11 citation statements)

References 15 publications

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“…6,17 However, very few studies are available regarding the influence of surgical removal of the infected vascular tissue on prognosis. Some reports describe surgical treatment of these infections with successful outcomes 8,20,21 and 1 study suggests that surgery confers a survival benefit 6 when combined with the recommended antibiotics, doxycycline, and hydroxychloroquine. Conversely, a recent retrospective study from the Netherlands suggests that surgical treatment of chronic Q fever is associated with all-cause and chronic Q fever-mortality.…”

Section: Introductionmentioning

confidence: 99%

Treatment and Prophylactic Strategy for Coxiella burnetii Infection of Aneurysms and Vascular Grafts

et al. 2016

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Coxiella burnetii vascular infections continue to be very severe diseases and no guidelines exist about their prevention. In terms of treatment, the benefit of the surgical removal of infected tissues has been suggested by 1 retrospective study.We present a case of a C burnetii abdominal aortic graft infection for which we observed a dramatic clinical and biological recovery after surgery. We thus performed a retrospective cohort study to evaluate the impact of surgery on survival and serological outcome for patients with Q fever vascular infections diagnosed in our center.Between 1986 and February 2015, 100 patients were diagnosed with Q fever vascular infections. The incidence of these infections has significantly increased over the past 5 years, in comparison with the mean annual incidence over the preceding 22 years (8.83 cases per year versus 3.14 cases per year, P = .001). A two-and-a-half-year follow-up was available for 66 patients, of whom 18.2% died. We observed 6.5% of deaths in the group of patients who were operated upon at 2 and a half years, in comparison with 28.6% in the group which were not operated upon (P = .02). Surgery was the only factor that had a positive impact on survival at 2 and a half years using univariate analysis [hazard ratio: 0.17 [95% CI]: [0.039–0.79]; P = .024]. Surgery was also associated with a good serological outcome (74.1% vs 57.1% of patients, P = .03). In the group of patients with vascular graft infections (n = 47), surgery had a positive impact on serological outcome at 2 and a half years (85.7% vs 42.9%, P < .001) [hazard ratio: 0.40 [95% CI]: [0.17–098]; P = .046] and tended to be associated with lower although not statistically significant mortality (11.1% vs 27.6% of deaths, P = .19).Surgical treatment confers a benefit in terms of survival following C burnetii vascular infections. However, given the high mortality of these infections and their rising incidence, we propose a strategy that consists of screening for vascular graft and aneurysms in the context of primary Q fever, to decide when to start prophylactic treatment, similar to the strategy recommended for the prophylaxis of Q fever endocarditis.

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Section: Introductionmentioning

confidence: 99%

Treatment and Prophylactic Strategy for Coxiella burnetii Infection of Aneurysms and Vascular Grafts

et al. 2016

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“…Alternatively, reconstruction using an autologous great saphenous spiral vein graft has been successfully performed. 16 It is unknown which surgical technique is preferable for vascular reconstruction, and the choice should be based on the experience of the surgeon.…”

Section: Discussionmentioning

confidence: 99%

Vertebral Osteomyelitis or Infected Abdominal Aortic Endograft? A Rare Case of Q Fever

Waelbers

Desmet

Munter

et al. 2020

Annals of Vascular Surgery

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Coxiella burnetii is the etiological agent of Q fever, a zoonosis. Vascular infections are associated with significant morbidity and mortality. Osteoarticular Q fever infections are rare. We describe a case of vertebral osteomyelitis with associated infection of an abdominal aortic endograft, caused by C. burnetii. Most probably, an initial pyogenic vertebral osteomyelitis extended locally to the endograft. Treatment consisted of antibiotic therapy and surgical resection of the infected aortic endograft and in situ reconstruction with autogenous superficial femoral vein grafts.

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“…Splanchnic artery aneurysms are rare, and SMA aneurysms only account for approximately 5% of all splanchnic artery aneurysms. These cases have a high mortality rate (38%–50%) that is related to intractable complications, such as internal ischemia and aneurysm rupture [ 1 , 2 ]. Infectious aneurysm is a complication of infective endocarditis that is caused by septic embolism, although it typically involves an intracranial vessel [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Open Surgical Repair Using the Femoral Vein for a Mycotic Superior Mesenteric Artery Aneurysm

Namkoong

Hong

Kim

et al. 2018

Korean J Thorac Cardiovasc Surg

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Superior mesenteric artery (SMA) aneurysms are rare and often fatal. A 72-year-old man had previously been admitted to the emergency room with epigastric pain and heart murmur. The echocardiographic diagnosis was vegetation on the aortic and mitral valves, with moderate regurgitation from both valves due to infective endocarditis. No aneurysm was detected on abdominal computed tomography, and emergency double-valve replacement was performed. On postoperative day 25, the patient experienced abrupt abdominal pain, and computed tomography revealed a mycotic SMA aneurysm. Open surgical repair of the SMA aneurysm was performed using the femoral vein, and the patient’s postoperative course was uneventful.

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Report of two in situ reconstructions with a saphenous spiral vein graft of Coxiella burnetii-infected aneurysms of the abdominal aorta

Cited by 19 publications

References 15 publications

Treatment and Prophylactic Strategy for Coxiella burnetii Infection of Aneurysms and Vascular Grafts

Treatment and Prophylactic Strategy for Coxiella burnetii Infection of Aneurysms and Vascular Grafts

Vertebral Osteomyelitis or Infected Abdominal Aortic Endograft? A Rare Case of Q Fever

Open Surgical Repair Using the Femoral Vein for a Mycotic Superior Mesenteric Artery Aneurysm

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