Surgical treatment of infected aortic aneurysm

Gregory L. Moneta, Lloyd M. Taylor, Richard A. Yeager, James M. Edwards, Alexander D. Nicoloff, Donald B. McConnell, John M. Porter

    Research output: Contribution to journalArticlepeer-review

    131 Scopus citations

    Abstract

    BACKGROUND: We report results of infected aortic aneurysms treated by a single group over 20 years. METHODS: Retrospective review. RESULTS: Seventeen patients were treated, 10 with infrarenal and 7 suprarenal infections. All had abdominal/back pain, 88% were febrile, 71% had leukocytosis, and 24% were hemodynamically unstable. The most common responsible organism was Staphylococcus aureus (29%) followed by Salmonella organisms (24%). All suprarenal infections were gram-positive organisms. Infrarenal infections were treated with preliminary axillofemoral bypass followed by aortic resection. Suprarenal infections were treated with either in situ prosthetic graff or patch repairs. Operative survival was 90% for infrarenal and 57% for suprarenal infections. Operative deaths occurred in the setting of overwhelming sepsis and/or severe preoperative hemodynamic instability. There was no limb loss, renal failure, or intestinal ischemia. Late deaths occurred in 4 patients at 1.3 to 6.3 years postoperatively and were unrelated to their aortic repairs. Nine patients remain alive with a median follow-up of 2 years. There have been no late aortic or graff infections. CONCLUSIONS: In the absence of hemodynamic instability and uncontrolled sepsis, infected aortic aneurysms can be successfully repaired with durable results.

    Original languageEnglish (US)
    Pages (from-to)396-399
    Number of pages4
    JournalAmerican journal of surgery
    Volume175
    Issue number5
    DOIs
    StatePublished - May 21 1998

    ASJC Scopus subject areas

    • Surgery

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