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Direct replacement of mycotic thoracoabdominal aneurysms
L H Hollier1, S R Money, B Creely
1Department of Vascular Surgery, Ochsner Clinic, New Orleans, LA 70121.
Journal of Vascular Surgery
|September 1, 1993
Summary
Surgical graft replacement with antibiotics effectively treats mycotic thoracoabdominal aneurysms, offering excellent long-term survival. Lifelong antibiotic therapy is recommended to manage persistent infections post-surgery.
Area of Science:
- Vascular Surgery
- Infectious Diseases
- Medical Microbiology
Background:
- Mycotic thoracoabdominal aneurysms present significant treatment challenges.
- Surgical intervention is often necessary but carries risks of infection and recurrence.
Observation:
- A study evaluated direct graft replacement with debridement and prolonged antibiotics in six patients.
- One early death occurred due to Staphylococcus aureus sepsis.
Findings:
- The remaining five patients demonstrated excellent long-term survival.
- Two patients died from unrelated causes; one had persistent infection; two were infection-free at 1.5 and 10 years.
- Percutaneous aspiration and antibiotic instillation may palliate recurrent infections.
Implications:
- In situ graft replacement combined with prolonged antibiotic administration is a viable treatment for mycotic thoracoabdominal aneurysms.
- Lifelong antibiotic therapy is recommended to prevent recurrent infections after surgery.
- This approach offers a favorable prognosis for patients with these complex vascular infections.