Outcomes of Open Repair of Mycotic Aortic Aneurysms with In Situ Replacement.
10.5090/kjtcs.2017.50.6.430
- Author:
Hyo Hyun KIM
1
;
Do Jung KIM
;
Hyun Chel JOO
Author Information
1. Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Korea. vietcomm@yuhs.ac
- Publication Type:Original Article
- Keywords:
Thoracic aortic aneurysm;
Abdominal aortic aneurysm;
Infected aneurysm;
Aorta, surgery
- MeSH:
Allografts;
Aneurysm;
Aneurysm, Infected;
Aortic Aneurysm*;
Aortic Aneurysm, Abdominal;
Aortic Aneurysm, Thoracic;
Bacteriology;
Debridement;
Follow-Up Studies;
Humans;
Male;
Mortality;
Polyethylene Terephthalates;
Polytetrafluoroethylene;
Prostheses and Implants;
Survival Rate;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2017;50(6):430-435
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Mycotic 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. METHODS: From 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. RESULTS: The 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%. CONCLUSION: This 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.
