Direct replacement of mycotic thoracoabdominal aneurysms

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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
PubMed

Insights

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.

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