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Surgical Outcome for Mycotic Aortic and Iliac Anuerysm.
MedLine Citation:
PMID:  21541801     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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:
Sheng-Yueh Yu; Hung-Chang Hsieh; Po-Jen Ko; Yao-Kuang Huang; Jaw-Ji Chu; Chun-Hui Lee
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-5-4
Journal Detail:
Title:  World journal of surgery     Volume:  -     ISSN:  1432-2323     ISO Abbreviation:  -     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-5-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Thoracic & Cardiovascular Surgery, Chang Gung Memorial Hospital, Chang Gung University, 5, Fushing Street, Gueishan Shiang, Taoyuan, 333, Taiwan, Republic of China.
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