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Tubercular pseudoaneurysms of aorta.
S K Choudhary1, A Bhan, S Talwar
1Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi.
The Annals of Thoracic Surgery
|October 18, 2001
Summary
Tubercular pseudoaneurysm, a rare aortic complication of tuberculosis, requires prompt treatment. Combining surgery with antitubercular therapy offers effective management for this condition.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Aortic Surgery
Background:
- Tubercular pseudoaneurysm of the aorta is a rare but significant complication of tuberculosis.
- The resurgence of tuberculosis, particularly drug-resistant strains and its link to AIDS, has increased the clinical relevance of tubercular pseudoaneurysms.
Observation:
- Five young patients (22-40 years) presented with tubercular pseudoaneurysms affecting various aortic segments.
- All patients had a history or evidence of active/treated pulmonary or pericardial tuberculosis and received antitubercular therapy.
- Rapid clinical deterioration was a common feature across all patients.
Findings:
- Surgical intervention, including graft interposition, patch repair, or direct closure, was performed on all patients.
- All patients survived surgery, with 4 remaining symptom-free at 18-36 months post-operation.
- One patient experienced recurrence and died during reoperation, highlighting the potential for late complications.
Implications:
- A combined approach of chemotherapy and surgical intervention yields favorable outcomes for tubercular pseudoaneurysms.
- This study underscores the importance of considering tuberculosis as a cause of aortic pseudoaneurysms, especially in endemic areas.
- Effective management necessitates a multidisciplinary approach integrating antimicrobial therapy and surgical repair.