11-year experience with anatomical and extra-anatomical repair of mycotic aortic aneurysms.
BACKGROUND
We have reviewed our management, of both ruptured and non-ruptured, abdominal and thoraco-abdominal mycotic aneurysms in order to determine the safety and efficacy of in situ and extra-anatomical prosthetic repairs.


METHODS
Data regarding presenting symptoms, investigations, operative techniques and outcome, were collected on patients treated at a singe centre over 11 years.


RESULTS
There were 11 men and four women, with a median age of 70 years (range, 24-79). All but one patient were symptomatic and six had a contained leak on admission. In six patients no organisms were identified in either blood or tissue cultures. Pre-operative CT identified; four infra-renal, four juxta-renal, three (Crawford thoraco-abdominal) type IV, three type III and one type II, aortic aneurysms. Thirteen were repaired with in situ prostheses and two required axillo-femoral prosthetic grafts. There were four early deaths. All surviving patients have been followed-up for a median duration of 38 months (range 1/2-112 months). There were two late deaths at 3 months (juxta-renal) and at 2 years (type III), the latter relating to graft infection.


CONCLUSIONS
In the absence of uncontrolled sepsis, repair of mycotic aortic aneurysms using prosthetic grafts can achieve durable results.
Kyriakides
C
C
Regional Vascular Unit, St Mary's Hospital, London, UK.
Kan
Y
Y
Kerle
M
M
Cheshire
N J
NJ
Mansfield
A O
AO
Wolfe
J H N
JH
D000368:Aged; D000785:Aneurysm, Infected / Q000453:epidemiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017544:Aortic Aneurysm, Abdominal / Q000453:epidemiology / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000453:epidemiology / Q000601:surgery*; D001019:Aortic Rupture / Q000453:epidemiology / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care
D000900:Anti-Bacterial Agents