BACKGROUND: The present study was designed to review surgical outcomes for mycotic aneurysm of the aortic or iliac arteries at a single center. METHODS: The study was based on retrospective chart review of patients undergoing operation for mycotic aneurysm. RESULTS: From January 1998 to December 2007, 56 patients received surgical treatment for mycotic aneurysm of the aortic or iliac arteries. Aneurysm sites included the aortic arch (n=5), proximal thoracic aorta (n=4), distal thoracic aorta (n=5), paravisceral aorta (n=5), juxtarenal aorta (n=4), infrarenal aorta (n=30), and iliac arteries (n=3). Salmonella was the leading pathogen (n=34). Nineteen patients with suprarenal lesions underwent in situ prosthetic graft replacement (n=17), extra-anatomic bypass (n=1), or endovascular aneurysm repair (EVAR) (n=1), and 37 patients with infrarenal lesions underwent the same procedures (n=16, 20, and 1, respectively). Overall in-hospital mortality was 23%. After discharge, four patients (7%) developed reinfection that led to fatal sepsis. Graft infection developed after three in situ prosthetic grafts (9%) and one extra-anatomic bypass (5%). Patients with suprarenal aortic lesions had poorer in-hospital (34%) and late (16%) mortality rates than those with infrarenal lesions (p=0.025). Those with suprarenal lesions also had a lower cumulative survival rate (p=0.016). CONCLUSIONS: The location of mycotic aneurysm was the determinant of mortality. Mycotic aneurysm of the suprarenal aorta has poor prognosis and requires alternative surgical treatment.
BACKGROUND: The present study was designed to review surgical outcomes for mycotic aneurysm of the aortic or iliac arteries at a single center. METHODS: The study was based on retrospective chart review of patients undergoing operation for mycotic aneurysm. RESULTS: From January 1998 to December 2007, 56 patients received surgical treatment for mycotic aneurysm of the aortic or iliac arteries. Aneurysm sites included the aortic arch (n=5), proximal thoracic aorta (n=4), distal thoracic aorta (n=5), paravisceral aorta (n=5), juxtarenal aorta (n=4), infrarenal aorta (n=30), and iliac arteries (n=3). Salmonella was the leading pathogen (n=34). Nineteen patients with suprarenal lesions underwent in situ prosthetic graft replacement (n=17), extra-anatomic bypass (n=1), or endovascular aneurysm repair (EVAR) (n=1), and 37 patients with infrarenal lesions underwent the same procedures (n=16, 20, and 1, respectively). Overall in-hospital mortality was 23%. After discharge, four patients (7%) developed reinfection that led to fatal sepsis. Graft infection developed after three in situ prosthetic grafts (9%) and one extra-anatomic bypass (5%). Patients with suprarenal aortic lesions had poorer in-hospital (34%) and late (16%) mortality rates than those with infrarenal lesions (p=0.025). Those with suprarenal lesions also had a lower cumulative survival rate (p=0.016). CONCLUSIONS: The location of mycotic aneurysm was the determinant of mortality. Mycotic aneurysm of the suprarenal aorta has poor prognosis and requires alternative surgical treatment.
Authors: G S Oderich; J M Panneton; T C Bower; K J Cherry; C M Rowland; A A Noel; J W Hallett; P Gloviczki Journal: J Vasc Surg Date: 2001-11 Impact factor: 4.268
Authors: Katherine E Brown; Kamaldeep Heyer; Heron Rodriguez; Mark K Eskandari; William H Pearce; Mark D Morasch Journal: J Vasc Surg Date: 2009-03 Impact factor: 4.268
Authors: Spyros I Papadoulas; Stavros K Kakkos; Pantelis A Kraniotis; Maria E Manousi; Markos N Marangos; Ioannis A Tsolakis Journal: J Glob Infect Dis Date: 2013-01