Surgical treatment of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta.
BACKGROUND
To review the outcome of infected aneurysms and pseudoaneurysms of the thoracic and abdominal aorta treated in a major teaching hospital.


METHODS
Between December 1994 and January 2003, 13 infected aortic aneurysms and pseudoaneurysms (5 thoracic, 4 paravisceral, 4 infrarenal) in 10 consecutive patients were treated surgically. Aortic debridement with in situ reconstruction is our standard practice. Endovascular repair was offered to suitable patients with thoracic aortic involvement.


RESULTS
There were six men and four women with a mean age of 63 years. The commonest pathogen was Salmonella species, accounting for 50% of the cases. Aortic debridement with in situ revascularization was performed for six patients with visceral reconstruction in four of them. One patient with aortic bifurcation involvement and gross purulent infection had ligation and debridement followed by right axillobifemoral bypass. Four infected thoracic aortic pseudoaneurysms in three other patients underwent endovascular repair. There was no hospital death, limb loss, renal failure, or intestinal ischemia. There were two late deaths from sepsis and pneumonia at 3 months and 77 months after operation. Eight patients were alive after a mean follow-up of 36 months and no late graft infection was evident.


CONCLUSIONS
Surgical treatment for infected aortic aneurysms with in situ reconstruction is associated with favorable outcome and good long-term result. Endovascular repair has a potential role.
Ting
Albert C W
AC
Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, Hong Kong.
Cheng
Stephen W K
SW
Ho
Pei
P
Poon
Jensen T C
JT
Tsu
James H L
JH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000382:microbiology* / Q000601:surgery*; D000785:Aneurysm, Infected / Q000601:surgery*; D017544:Aortic Aneurysm, Abdominal / Q000382:microbiology* / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000382:microbiology* / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000209:etiology; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000473:pathology / Q000601:surgery*; D018805:Sepsis / Q000209:etiology