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Related Experiment Videos

Patch closure of aortic annulus mycotic aneurysms.

A C Fiore, T D Ivey, P P McKeown

    The Annals of Thoracic Surgery
    |October 1, 1986
    PubMed
    Summary

    This study shows that patch closure of mycotic aneurysms in the aortic annulus is an effective treatment, leading to good outcomes for patients with bacterial endocarditis.

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    Area of Science:

    • Cardiovascular Surgery
    • Infectious Diseases
    • Cardiac Surgery

    Background:

    • Mycotic aneurysms of the aortic annulus are serious complications of bacterial endocarditis.
    • Patients often present with severe symptoms like congestive heart failure and are in advanced NYHA functional classes.

    Purpose of the Study:

    • To evaluate the effectiveness of a surgical technique for treating mycotic aneurysms of the aortic annulus.
    • To assess the outcomes and long-term survival of patients undergoing this procedure.

    Main Methods:

    • Surgical debridement of the abscess cavity followed by closure of the aneurysm orifice with a Dacron or pericardial patch.
    • Implantation of a prosthetic valve (bioprosthetic or mechanical) onto the native annulus and the closure patch.
    • Treatment of 23 patients between 1978 and 1985 with bacterial endocarditis and aortic annulus mycotic aneurysms.

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    Main Results:

    • A high success rate with 20 out of 23 patients surviving (87%) at a mean follow-up of 1 year.
    • All survivors improved to NYHA Functional Class I, indicating significant functional recovery.
    • Low mortality with only 3 deaths (1 perioperative, 2 late), none related to residual infection or aortic insufficiency.

    Conclusions:

    • Patch closure of mycotic aneurysms involving the aortic annulus is an effective surgical alternative.
    • This technique allows for thorough debridement and tension-free closure, facilitating prosthetic valve placement at the native annulus level.
    • It avoids complex aortic root and coronary artery reconstructions, offering a simpler approach for selected patients.