Extra-Anatomic Reconstruction for Infected Aorta

Background: Mycotic aneurysms are rare in this age of antibiotic. But, they still represent as the life-threatening disease because of their high incidence of rupture and high rate of re-infection. Treatment of mycotic aortic aneurysm still remains confusing, especially in patients with severe aortic infection. Methods: From Oct. 1999 to Sep. 2002, there were 4 patients suffered from infected aorta with mycotic aneurysm formation. One was in descending thoracic aorta, 3 were in abdominal aorta. All 4 patients received the technique of extra-anatomic reconstruction due to severe periaortic invasion and preoperation impending rupture. We analyzed the data including age, gender, pre-operative characteristics, lesion location, operative procedure, complications, bacteriology, and antibiotic use. Results: The underlying infections of the aorta were treated successfully in all 4 patients. No recurrence of infected aorta and no infection of extra-anatomic prosthetic grafts were noted. Just 1 patient had neurologic sequela due to spinal artery ligation. All patients were caused by Salmonella infection. Appropriate antibiotics were given intravenously for 6 weeks. All patients discharged under stable condition. Conclusions: Although surgical treatments for mycotic aneurysms include extra-anatomic and in-situ reconstructions, recurrence and prosthetic infections still make surgeon in a delimma. Our preliminary experience demonstrates that short-term outcomes of extra-anatomic reconstruction for mycotic aneurysm is satisfactory and demonstrates an improved disease-related survival. However, successful initial control of infection, a prerequisite for survival, is done with extra-anatomic reconstruction in our series.

並列關鍵字

extra-anatomic reconstruction ； infected aorta ； mycotic aneurysm

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