PMID: 8464080Apr 1, 1993Paper

Infected infrarenal aortic aneurysms: when is in situ reconstruction safe?

Journal of Vascular Surgery
J M FichelleJ M Cormier

Abstract

Twenty-five infected infrarenal aortic aneurysms operated on between 1968 and 1989 were reviewed. They were classified into post-embolic (mycotic) aneurysms (group I), infective aortitis (group II), and infected atherosclerotic aneurysms (group III). Aortoduodenal fistulas were found in eight patients and aortocaval in two. Five patients were operated on in a state of shock, and 12 had preoperative positive blood cultures. Surgical procedures included in situ reconstruction of the aorta (n = 21) and extra-anatomic bypass associated with aneurysmal resection (n = 4). In 19 patients, prostheses were covered with omental flaps, and antibiotics were continued for more than 6 weeks in all patients. In patients who underwent in situ reconstruction, three deaths were related to the initial surgery. All surviving patients were regularly followed up, and none showed any sign of late septic recurrence. In patients who underwent extra-anatomic bypass, two died in the postoperative period, one underwent reoperation 2 years after the initial surgery, and the last patient is doing well. Positive postoperative blood cultures (n = 4) revealed persistent sepsis: two cholecystitis, one spondylitis, and one aortic infection. An exhaustive review ...Continue Reading

Citations

Jan 11, 2011·QJM : Monthly Journal of the Association of Physicians·M FiskD J B Marks
Jan 1, 2011·Annals of Vascular Diseases·Kosaku NishigawaKazuo Tanemoto
Mar 12, 1999·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·M J BuckmasterR W Thompson

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