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Infected thoracoabdominal aortic aneurysms including the major abdominal branches in 4 cases

Hitoshi Inafuku1, Shigenobu Senaha, Yuji Morishima

  • 1Thoracic and Cardiovascular Surgery, Division Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan.

Annals of Thoracic and Cardiovascular Surgery : Official Journal of the Association of Thoracic and Cardiovascular Surgeons of Asia
|June 26, 2008
PubMed

Insights

This study reports on surgical repair for four infected thoracoabdominal aortic aneurysms (TAAA). The described technique, including graft replacement and artery reimplantation, showed promise in preventing graft infection post-surgery.

Area of Science:

  • Vascular Surgery
  • Aortic Aneurysm Research
  • Infectious Disease Management in Surgery

Background:

  • Infected thoracoabdominal aortic aneurysms (TAAA) pose significant surgical challenges.
  • Repair often involves complex reconstruction, especially when abdominal branches are involved.
  • High rates of morbidity and mortality are associated with TAAA infections.

Observation:

  • Four cases of infected TAAA with involvement of abdominal branches were surgically repaired.
  • The procedure included debridement, in situ four-branched Dacron graft replacement, and omental wrapping.
  • Reimplantation of intercostal and lumbar arteries was performed to prevent spinal ischemia.

Findings:

  • One hospital death (25%) occurred, and one patient (25%) experienced postoperative paraplegia.
  • No instances of postoperative graft infection were observed during a mean follow-up of 15 months.
  • Intravenous and lifelong oral antibiotic administration was part of the postoperative management.

Implications:

  • The presented surgical strategy may effectively prevent postoperative graft infection in complex TAAA cases.
  • Careful management of visceral and spinal artery perfusion is crucial for successful TAAA repair.
  • Further research is warranted to validate this approach in a larger patient cohort.

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