Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Outcomes of Open Repair of Mycotic Aortic Aneurysms with In Situ Replacement

  • Kim, Hyo-Hyun (Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Kim, Do Jung (Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine) ;
  • Joo, Hyun-Chel (Department of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine)
  • Received : 2017.05.12
  • Accepted : 2017.07.31
  • Published : 2017.12.05
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Abstract

Background: Mycotic aortic aneurysms are rare and life-threatening. Unfortunately, no established guidelines exist for the treatment of patients with mycotic aortic aneurysms. The purpose of this study was to evaluate the midterm outcomes of the open repair of mycotic thoracic and thoracoabdominal aneurysms and suggest a therapeutic strategy. Methods: From 2006 to 2016, 19 patients underwent open repair for an aortic aneurysm. All infected tissue was extensively debrided and covered with soft tissue. We recorded the clinical findings, anatomic location of the aneurysm, bacteriology results, antibiotic therapy, morbidity, and mortality for these cases. Results: The median age was $62{\pm}7.2years$ (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was $44.5{\pm}4.9mm$. The mean time from onset of illness to surgery was $14.5{\pm}2.4days$. Aortic continuity was restored in situ with a Dacron prosthesis (79%), homograft (16%), or Gore-Tex graft (5%). Soft-tissue coverage of the prosthesis was performed in 8 patients. The mean follow-up time was $43.2{\pm}11.7months$. The early mortality rate was 10.5%, and the 5-year survival rate was $74.9%{\pm}11.5%$. Conclusion: This study showed acceptable early and midterm outcomes of open repair of mycotic aneurysms. We emphasize that aggressive intraoperative debridement with soft-tissue coverage results in a high rate of success in these high-risk patients.

Keywords

References

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