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Surgery for infected aneurysm of the aortic arch

Ron-Bin Hsu1, Fang-Yue Lin

  • 1Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.

The Journal of Thoracic and Cardiovascular Surgery
|November 3, 2007
PubMed
Abstract

Insights

Infected aortic arch aneurysms are rare but deadly. Surgical treatment with in situ graft replacement has high mortality, with nontyphoid Salmonella being the most common pathogen.

Area of Science:

  • Cardiovascular Surgery
  • Infectious Diseases

Background:

  • Infected aneurysms of the aortic arch are rare, life-threatening conditions requiring surgical intervention.
  • Nontyphoid Salmonella is identified as the predominant pathogen in these cases.

Purpose of the Study:

  • To report the surgical experience and outcomes of treating infected aortic arch aneurysms.
  • To analyze the efficacy and complications associated with current treatment modalities.

Main Methods:

  • A retrospective chart review was conducted.
  • Ten patients with infected aortic arch aneurysms treated between 1995 and 2006 were analyzed.
  • Surgical intervention involved in situ graft replacement under deep hypothermic circulatory arrest.

Main Results:

  • Nontyphoid Salmonella (50%) and Staphylococcus aureus (20%) were the most common pathogens.
  • Hospital mortality was 10%, with major postoperative complications in 70% of patients, including hypoxic encephalopathy.
  • Thoracotomy approach (17% mortality) showed better outcomes than sternotomy (67% mortality) for distal arch aneurysms.

Conclusions:

  • Infected aortic arch aneurysms are uncommon, with nontyphoid Salmonella being a frequent cause.
  • Current in situ graft replacement strategies are linked to significant mortality and morbidity.
  • Enhancements in cerebral protection and surgical techniques are crucial for improving patient outcomes.

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