title: Infected thoracoabdominal aortic aneurysms including the major abdominal branches in 4 cases.
abstract: We present four cases of infected thoracoabdominal aortic aneurysm (TAAA), including abdominal branches that underwent surgical repair. The mean age of patients at the time of operation was 61+/-18 (range: 39-83) years. The extent of the aneurysm was Crawford type III in 1 case and type IV in the other 3. They all underwent an emergency or urgent operation, which consisted of a debridement of the infected tissue, in situ four-branched Dacron graft replacement, and iodine gauze packing for 48 h followed by omental wrapping of the graft. To prevent postoperative spinal ischemia, intercostal and lumbar arteries were reimplanted under motor-evoked potential (1.25 pairs per patient). There was one (25%) hospital death, but postoperative graft infection did not occur in these present cases during a mean follow-up period of 15+/-43 (1-96) months. Antibiotics were administered intravenously for 8 weeks after the operation, then continued orally for a lifelong period. Postoperatively, paraplegia occurred in one (25%) patient. Our strategy for infected TAAA including major abdominal branches may prevent postoperative graft infection.
authors.affiliation: Thoracic and Cardiovascular Surgery, Division Department of Bioregulatory Medicine, Faculty of Medicine, University of the Ryukyus, Nishihara, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inafuku
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Senaha
authors.forename: Yuji
authors.initials: Y
authors.lastname: Morishima
authors.forename: Takaaki
authors.initials: T
authors.lastname: Nagano
authors.forename: Katsuya
authors.initials: K
authors.lastname: Arakaki
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yamashiro
authors.forename: Yukio
authors.initials: Y
authors.lastname: Kuniyoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation; D003646:Debridement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000209:etiology / Q000517:prevention & control*; D020760:Spinal Cord Ischemia / Q000209:etiology / Q000517:prevention & control*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D011093:Polyethylene Terephthalates