HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pasic, M. Articles by Turina, M. Search for Related Content PubMed PubMed Citation Articles by Pasic, M. Articles by Turina, M.

The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 321-326, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

In situ repair of mycotic aneurysm of the ascending aorta

M Pasic, T Carrel, L von Segesser and M Turina
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.

Between 1969 and 1990 six patients (aged 14 to 64 years, mean 43 years) underwent in situ reconstruction for mycotic aneurysm of the ascending aorta. The primary source of infection was endocarditis in three patients (subacute bacterial endocarditis [n = one patient], sepsis with acute endocarditis [n = one patient]), sepsis with sternal osteomyelitis in one, sepsis with purulent pericarditis in one, and generalized febrile illness in one. In five of six patients the treatment consisted of the excision of changed tissue combined with a composite graft (n = one patient), a xenopericardial patch repair (n = one patient), a Dacron graft repair and aortic valve replacement (n = one patient), a Dacron graft repair alone (n = one patient), and a lateral suture combined with double valve replacement (n = one patient). In one patient with perforation of the mycotic aneurysm into the pulmonary artery, the place of rupture was oversewn without excision of the aortic or pulmonary artery tissue. Two patients with local pericardial inflammation were reoperated on during the hospital stay; one of them because of recurrent mycotic aneurysm of the ascending aorta at the other location and the other because of infection of the suture line after the Dacron patch repair. Antibiotic therapy was intravenously administered for 2 to 12 weeks postoperatively and continued orally for 4 to 8 weeks. The mean observation time was 6 years (range 4 months to 16 years). There was no late graft infection, except the chronic infection of the suture line in one patient who died suddenly 4 months after the operation. There was no early death, and there were three late deaths (chronic myocardial failure, one patient, chronic renal failure, one patient, sudden death, one patient). We concluded that in situ reconstruction for mycotic aneurysm of the ascending aorta combined with prolonged antibiotic therapy is an appropriate procedure with satisfactory early and good long-term results.

This article has been cited by other articles:

				T. Katsumata, N. Moorjani, G. Vaccari, and S. Westaby Mediastinal false aneurysm after thoracic aortic surgery Ann. Thorac. Surg., August 1, 2000; 70(2): 547 - 552. [Abstract] [Full Text] [PDF]

				S. Kuki, K. Taniguchi, S. Miyagawa, and H. Takano Multiple mycotic arch-thoraco-abdominal aortic aneurysms: a successful case of in situ graft replacement Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 184 - 186. [Abstract] [Full Text] [PDF]

				T. Katsumata and S. Westaby Homograft Aortic Replacement for Infected Mediastinal False Aneurysm Ann. Thorac. Surg., November 1, 1997; 64(5): 1464 - 1466. [Abstract] [Full Text]

				Y.-F. Chen, P.-Y. Lin, H.-W. Yen, and C.-C. Lin Double Mycotic Aneurysms of the Ascending Aorta Ann. Thorac. Surg., February 1, 1997; 63(2): 529 - 531. [Abstract] [Full Text]

				M. Pasic Mycotic Aneurysm of the Aorta: Evolving Surgical Concept Ann. Thorac. Surg., April 1, 1996; 61(4): 1053 - 1054. [Full Text]

				C. Knosalla, Y. Weng, A. C. Yankah, J. Hofmeister, and R. Hetzer Using Aortic Allograft Material to Treat Mycotic Aneurysms of the Thoracic Aorta Ann. Thorac. Surg., April 1, 1996; 61(4): 1146 - 1152. [Abstract] [Full Text]

				P. Vogt, M. Pasic, L. von Segesser, T. Carrel, and M. Turina Cryopreserved aortic homograft for mycotic aneurysm J. Thorac. Cardiovasc. Surg., March 1, 1995; 109(3): 589 - 591. [Full Text]