title: The treatment of infectious aneurysms in the thoracic aorta; our experience in treating five consecutive patients.
abstract: The surgical strategy for infected thoracic aortic aneurysms (ITAA) remains controversial. Effective antibiotic therapy is mandatory and surgical intervention is indicated only to prevent an aneurysmal rupture. In-situ reconstruction through an aseptic route is ideal; however, urgent surgery is often required in the uncontrolled infectious phase. Five patients were recently treated surgically for ITAA. They were all males with a mean age of 61.2 (range: 58-66) years. Two patients were operated on urgently in the active infectious phase due to impending aneurysmal rupture. A total arch reconstruction with an extra-anatomical bypass between the ascending aorta and both femoral arteries in one and an extended aortic arch resection with an in-situ graft reconstruction were performed in the other. The other three patients underwent in-situ graft reconstructions in the controlled infectious phase. Four patients had multiple aneurysms, including nine saccular or nodular aneurysms. Short-interval computed tomography (CT) re-examinations revealed a rapid enlargement of the aneurysms and confirmed the diagnosis. All patients successfully survived and are doing well without any evidence of a recurrent aortic infection. The surgical strategy for ITAA should be determined on a case-by-case basis under a careful follow-up with short-interval CT re-examinations.
authors.affiliation: Department of Cardiac Surgery, Nagoya University Graduate School of Medicine, 65 Thurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakashima
authors.forename: Akihiko
authors.initials: A
authors.lastname: Usui
authors.forename: Hideki
authors.initials: H
authors.lastname: Oshima
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ueda
mesh_terms: D000368:Aged; D000785:Aneurysm, Infected / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000601:surgery*; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents