Graft for mycotic thoracic aortic aneurysm: omental wrapping to prevent infection.
Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 +/- 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.
Kuniyoshi
Yukio
Y
Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, 207 Uehara Nishihara-cho, Okinawa 903-0215, Japan. kuni9244@med.u-ryukyu.ac.jp
Koja
Kageharu
K
Miyagi
Kazufumi
K
Uezu
Tooru
T
Yamashiro
Satoshi
S
Arakaki
Katuya
K
D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000401:mortality / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000401:mortality / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009852:Omentum / Q000601:surgery*; D016459:Prosthesis-Related Infections / Q000401:mortality / Q000517:prevention & control*; D013524:Surgical Flaps; D015996:Survival Rate; D016896:Treatment Outcome