Strategy and Treatment Results for Infected Aortic Aneurysms

DOI 4 Citations 16 References

Bibliographic Information

Other Title
  • 感染性大動脈瘤の治療方針と成績

Search this article

Abstract

Infected aortic aneurysms are life-threatening and these diagnosis and treatment are challenging. We describe our experience with 7 patients who had infected aortic aneurysms treated at our hospital between January 2000 and December 2005. Three patients had thoracic aortic aneurysms (TAA), 2 had thoracoabdominal aortic aneurysms (TAAA), and 2 had infra-renal abdominal aneurysms (AAA). Four patients had ruptured aneurysms, including pseudoaneurysms. Positive results were obtained for blood cultures in 2 patients, pericardial effusion in 1, and intraoperative tissue specimens in 2; no organisms were identified in the other 2 patients, probably because of prior antibiotic therapy. Three patients had Staphylococcal infections, and the others had Klebsiella and Salmonella infections. Antibiotics were given on establishing the diagnosis of infected aortic aneurysm. Operations were done 11.7 ± 8.2 (0-21) days after admission to our hospital. Two patients with TAA underwent aortic patch plasty with autologous arterial grafts. One patient with TAA received in situ reconstruction with a Dacron graft covered with the greater omentum. TAAA extra-anatomical bypass was performed in 2 patients. The aortic stump was closed off after excision of the aneurysm, and the visceral branches were revascularized with saphenous vein interposition grafts. One patient with AAA received in situ reconstruction with a Dacron graft, and 1 patient with AAA underwent axillobifemoral bypass because of occlusion of the abdominal aorta. Long-term antibiotic treatment was given postoperatively. Hepatic abscess, sepsis, and postoperative paralysis developed in 1 patient with TAAA, and pneumonia and perforation of colon, both of which were treated successfully, developed in another with TAAA. There was 1 in-hospital death. The other 6 patients were followed up on an outpatient basis. Our experience suggests that our strategies for the management of infected aortic aneurysms, surgical treatment based on location and type of aneurysms, and intensive antibiotic therapy can achieve good long-term results.

Journal

Citations (4)*help

See more

References(16)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top