Surgical Mortality in Patients with Infected Aortic Aneurysms

Fillmore, Anthony J; Valentine, R. James

doi:10.1016/s1072-7515(02)01607-1

Cited by 140 publications

(142 citation statements)

References 14 publications

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“…Mycotic aortic aneurysms (MAA) comprise only a small minority of aortic aneurysms [4,5] and have been associated with an aggressive course with rapid progression. A large contemporary series of MAA have reported a high frequency of rupture at the time of presentation, ranging from 38% to 85% [4, 6,8] with in-hospital mortality as high as 36% to 40% [5,13]. Causative organisms most frequently include Salmonella species and Staphylococcus aureus, with Streptococcus species and E. coli identified less commonly.4,8 In the majority of patients, at least one comorbid condition causing immunosuppression can be identified, including diabetes mellitus, steroid use, and chronic renal failure [4].…”

Section: Discussionmentioning

confidence: 99%

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

Ward¹,

Ruddy²

2017

J Clin Case Rep

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Mycotic aortic aneurysms are an aggressive form of degenerative remodeling reported more commonly in immunosuppressed patients. These aneurysms carry a high risk of progression to rupture, fulminant sepsis, and death, and therefore require prompt operative intervention. The human immunodeficiency virus (HIV) has also been associated with a broad spectrum of vascular disease, including development of aneurysms, however these have typically been identified in the peripheral vasculature. We report the case of a 71-year-old, HIV-positive male who presented with Escherichia coli bacteremia and aortitis which rapidly progressed to a ruptured infrarenal mycotic aortic aneurysm. He was managed successfully with open debridement and in situ implantation of a rifampin-soaked prosthetic graft as well as long-term antibiotic therapy. Here, we review the epidemiology, pathophysiology, and optimal surgical treatment of mycotic aortic aneurysms.

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Section: Discussionmentioning

confidence: 99%

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

Ward¹,

Ruddy²

2017

J Clin Case Rep

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“…Our case illustrates how clinical findings and inflammatory markers may be insufficient to detect early complications. The reported risk of rupture in mycotic aneurysms is high, 50-80% (Ting et al, 2005;Fillmore and Valentine, 2003) and if rupture occurs, mortality exceeds 75% (Blanchard 1999).…”

Section: Discussionmentioning

confidence: 99%

<i>Campylobacter Fetus</i> Infection of the Aorta: A Case Report and Review of Literature

Ghimire¹,

Urban²,

Lee³

et al. 2015

American Journal of Infectious Diseases

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Campylobacter is a gram negative bacterium that exhibits tissue tropism. We report a case of Campylobacter fetus bacteremia associated with infra-renal abdominal aortitis. The patient was a poor surgical candidate so she was initially treated only medically. Her course was complicated by the development of a pseudoaneurysm. An endovascular stent was placed and the patient was given 4 more weeks of antibiotics. The patient continues to do well several months after stent placement. This case illustrates the success of medical treatment combined with stent placement in a patient who could not undergo surgery for an infected abdominal aortic pseudoaneurysm.

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“…Although admirable surgical outcomes have been reported, with both early and late mortalities as low as 5%, an early mortality rate of 5-40% and an at least 30% late mortality rate after open surgical repair of infected aortic aneurysms were demonstrated in most literatures [9-14, 16, 17, 77, 112-118]. Generally, the surgical outcomes for infected aneurysms with an infrarenal location were better than those involving the aortic arch and descending thoracic, thoracoabdominal, supra-renal, and juxta-renal aorta [11,13,16,116]. An infected aneurysm of the ascending aorta is rare, and a successful surgical treatment has been reported in Refs.…”

Section: Traditional Open Repairmentioning

confidence: 99%

“…Emergency operation is indispensable to salvage patients presenting with ruptured infected aortic aneurysms. Since the infectious process is usually not suppressed sufficiently even with proper antibiotic treatment course at the time of operation in these patients, the risk of postoperative persistent or even outbreak of infection is high [16][17][18]. Furthermore, the management of infected aortic aneurysms with aerodigestive communications is much more complex and remains inconclusive according to current evidence [18][19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

Infected Aortic Aneurysms

Lin¹,

Kan²

2017

Aortic Aneurysm

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Infected aortic aneurysms are surgical urgencies, requiring prompt management to avoid the development of catastrophic complications. Although traditional open surgery composed of radical debridement and aortic reconstruction remains the gold-standard, many favorable results of the endovascular repair strategy have been reported. In this chapter, the etiology, bacteriology, clinical manifestation, and diagnostic criteria of infected aortic aneurysms will be discussed in detail at first, followed by a comprehensive review of both traditional open surgery and endovascular repair, based on current evidences and the authors' institutional experience. Along with long-term oral antibiotic suppression and aggressive adjunctive procedures, endovascular repair for uncomplicated infected aortic aneurysms could be a definite treatment alternative to traditional open surgery in the endovascular era.

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Surgical Mortality in Patients with Infected Aortic Aneurysms

Cited by 140 publications

References 14 publications

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

Ruptured Mycotic Aortic Aneurysm Secondary to Escherichia Coli Bacteremia in an HIV-Positive Patient

<i>Campylobacter Fetus</i> Infection of the Aorta: A Case Report and Review of Literature

Infected Aortic Aneurysms

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