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Outcomes of Open Repair of Mycotic Aortic Aneurysms with In Situ Replacement

 Hyo-Hyun Kim  ;  Do Jung Kim  ;  Hyun-Chel Joo 
 Korean Journal of Thoracic and Cardiovascular Surgery, Vol.50(6) : 430-435, 2017-12 
Journal Title
 Korean Journal of Thoracic and Cardiovascular Surgery 
Issue Date
Abdominal aortic aneurysm ; Aorta, surgery ; Infected aneurysm ; Thoracic aortic aneurysm
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±7.2 years (range, 16 to 78 years), 13 patients (68%) were men, and the mean aneurysm size was 44.5±4.9 mm. The mean time from onset of illness to surgery was 14.5±2.4 days. 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±11.7 months. The early mortality rate was 10.5%, and the 5-year survival rate was 74.9%±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.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Jung(김도정)
Kim, Hyohyun(김효현) ORCID logo https://orcid.org/0000-0002-1608-9674
Joo, Hyun Chel(주현철) ORCID logo https://orcid.org/0000-0002-6842-2942
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