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Primary aortic infections and infected aneurysms

N Sekar1

  • 1Senior Consultant Vascular Surgeon, Apollo Hospitals, Chennai, India, President, Vascular Society of India.

Annals of Vascular Diseases
|April 5, 2013
PubMed

Insights

Primary aortic infections and infected aortic aneurysms are rare but life-threatening bacterial conditions. Prompt antibiotics and aggressive surgery, including aneurysm excision and aortic reconstruction, are crucial for survival.

Area of Science:

  • Vascular Surgery
  • Infectious Diseases
  • Cardiovascular Medicine

Background:

  • Primary infections of the aorta and infected aortic aneurysms are rare, life-threatening conditions.
  • Bacterial infection typically arises from atheromatous plaques or pre-existing aneurysms during bacteremia.
  • Hospital mortality rates range significantly from 16-44%.

Purpose of the Study:

  • To review the etiology, treatment, and outcomes of primary aortic infections and infected aortic aneurysms.
  • To highlight the increasing role of Gram-negative bacilli in aortic infections.
  • To emphasize the importance of combined antibiotic and surgical management.

Main Methods:

  • Review of existing literature on primary aortic infections and infected aortic aneurysms.
  • Analysis of causative organisms, treatment strategies, and patient outcomes.
  • Comparison of mortality rates based on bacterial type and aneurysm location.

Main Results:

  • Gram-positive bacteria remain common, but Gram-negative bacilli are increasingly implicated.
  • Gram-negative infections are associated with higher mortality, often involving suprarenal aneurysms and increased rupture risk.
  • Optimal treatment involves aggressive surgical excision, in situ aortic reconstruction, and appropriate antibiotic therapy.

Conclusions:

  • Effective management requires prompt diagnosis, appropriate antibiotics, and aggressive surgical intervention.
  • In situ reconstruction of the aorta is the preferred surgical approach.
  • Long-term antibiotic therapy is essential to prevent reinfection, with high mortality noted for emergency operations, advanced age, and non-Salmonella infections.
Keywords:
aortaaortitismycotic aneurysmpseudo aneurysm

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