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Peripheral mycotic aneurysms in infective endocarditis.
Yavuz Enç1, Bayer Cinar, Cüneyt Konuralp
1Siyami Ersek Thoracic and Cardiovascular Surgery Center, Department of Cardiovascular Surgery, Istanbul, Turkey.
The Journal of Heart Valve Disease
|June 25, 2005
Summary
Surgical intervention is crucial for treating mycotic aneurysms (MAs) complicating infective endocarditis (IE). Complete revascularization and appropriate antimicrobial therapy are key to successful outcomes and limb salvage in these complex cases.
Area of Science:
- Cardiovascular Surgery
- Infectious Diseases
- Vascular Surgery
Background:
- Infective endocarditis (IE) is a severe condition with high mortality.
- Mycotic aneurysms (MAs) are rare but serious complications of IE.
- Surgical intervention is often necessary for treating extracranial MAs.
Purpose of the Study:
- To evaluate the outcomes of surgical intervention for peripheral mycotic aneurysms in patients with infective endocarditis.
- To identify critical factors for successful treatment and prevention of complications.
Main Methods:
- A retrospective review of 238 patients with IE treated between 1990 and 2003.
- Analysis of 10 patients who underwent surgical intervention for peripheral MAs.
- Evaluation of surgical techniques, graft materials, and postoperative management.
Main Results:
- Limb salvage was achieved in 90% of patients.
- Successful revascularization was performed using autologous saphenous vein or PTFE grafts.
- Complications included graft rupture, embolism, and death in two patients.
Conclusions:
- Complete revascularization is essential for treating peripheral MAs in IE.
- Adequate resection, antimicrobial therapy, and managing size discrepancies are critical for preventing complications.
- Graft material type is less important than surgical technique and infection control.