Document Detail


Infected aneurysm of the thoracic aorta.
MedLine Citation:
PMID:  18241748     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Infected aneurysm of the thoracic aorta is rare and can be fatal without surgical treatment. We review our experience with 32 patients during a 12-year period.
METHODS: Retrospective chart review.
RESULTS: Between 1995 and 2007, 32 patients (24 men, 8 women) with infected aneurysms of thoracic aorta were treated at our hospital. Their median age was 74 years (range, 50-88 years). Of the 28 pathogens isolated, the most common responsible microorganism was nontyphoid Salmonella in 16 (57%), followed by Staphylococcus aureus in four (14%) and Mycobacterium tuberculosis in three (11%). The site of infection was the aortic arch in 13 patients, proximal descending thoracic aorta in 10, and distal descending thoracic aorta in 9. Seven patients had medical treatment alone, and 25 patients underwent in situ graft replacement. The hospital mortality rate of medical treatment alone was 57%, and the hospital mortality rate of in situ grafting was 12%. Of the 22 operated-on survivors, there were 11 late deaths, four of which were aneurysm-related. The aneurysm-related mortality rate in operated-on patients was 28%. Of 16 patients with infection caused by nontyphoid Salmonella, 13 patients underwent in situ grafting, with a hospital mortality rate of 8% and aneurysm-related mortality rate of 31%.
CONCLUSIONS: Infected aneurysm of the thoracic aorta was uncommon. The clinical results of in situ grafting were improving. Nontyphoid Salmonella was the most common responsible microorganism, and the prognosis of infection caused by Salmonella was not dismal. Outcomes of other management strategies, such as endovascular stenting, need to be compared with these results.
Authors:
Ron-Bin Hsu; Fang-Yue Lin
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  47     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-04     Completed Date:  2008-03-13     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  270-6     Citation Subset:  IM    
Affiliation:
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Aneurysm, Infected / drug therapy,  microbiology,  mortality,  surgery,  therapy*
Anti-Bacterial Agents / therapeutic use*
Aortic Aneurysm, Thoracic / drug therapy,  microbiology,  mortality,  surgery,  therapy*
Blood Vessel Prosthesis Implantation*
Debridement*
Female
Follow-Up Studies
Hospital Mortality
Humans
Male
Middle Aged
Research Design
Retrospective Studies
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents

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