Korean J Thorac Cardiovasc Surg.  2017 Dec;50(6):430-435. 10.5090/kjtcs.2017.50.6.430.

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

• Kim HH
• Kim DJ
• Joo HC

• KMID: 2398373
• DOI: http://doi.org/10.5090/kjtcs.2017.50.6.430

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.

Keyword

Thoracic aortic aneurysm; Abdominal aortic aneurysm; Infected aneurysm; Aorta, surgery

MeSH Terms

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
Polyethylene Terephthalates
Polytetrafluoroethylene