In situ replacement for mycotic aneurysms on the thoracic and abdominal aorta using rifampicin-bonded grafting and omental pedicle grafting.

Abstract

BACKGROUND:

The objective of this report is to discuss the efficacy of in situ replacement for treating mycotic aneurysm, particularly using rifampicin-bonded grafts and omental pedicle grafts, on the basis of our 7 years of experience.

METHODS:

Between December 2003 and December 2010, we performed surgical treatments in 23 patients (for the thoracic aorta in 6 patients, for the thoracoabdominal aorta in 8 patients, and for the abdominal aorta in 9 patients; 7 emergency, 10 urgent, and 6 elective operations) with mycotic aneurysm by using rifampicin-bonded grafting and omental pedicle grafting.

RESULTS:

One patient died in hospital because of local recurrent infection. One patient required an additional operation on another aortic site, and 3 patients had spinal cord injuries (2 transient and 1 permanent). Overall survival at 5 years was 95%, and the rate of freedom from aortic events at 5 years was 86%.

CONCLUSIONS:

In situ replacement using rifampicin-bonded grafting and omental pedicle grafting is effective for treating mycotic aneurysms of the thoracic and abdominal aorta.

• Authors: Naomichi Uchida, Akira Katayama, Kentaro Tamura, Sutoh Miwa, Kuraoka Masatsugu, Taijiro Sueda
• Journal: The Annals of thoracic surgery (Ann Thorac Surg) Vol. 93 Issue 2 Pg. 438-42 (Feb 2012) ISSN: 1552-6259 [Electronic] Netherlands
• PMID: 22054654 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Chemical References

• Anti-Bacterial Agents
• Polyethylene Terephthalates
• Rifampin

Topics

• Aged
• Aged, 80 and over
• Aneurysm, Infected (drug therapy, surgery)
• Anti-Bacterial Agents (therapeutic use)
• Aortic Aneurysm, Abdominal (drug therapy, surgery)
• Aortic Aneurysm, Thoracic (drug therapy, surgery)
• Bacteremia (complications, drug therapy)
• Blood Vessel Prosthesis Implantation (methods)
• Combined Modality Therapy
• Elective Surgical Procedures
• Enterobacteriaceae Infections (drug therapy, surgery)
• Female
• Gram-Positive Bacterial Infections (drug therapy, surgery)
• Humans
• Male
• Middle Aged
• Omentum
• Polyethylene Terephthalates
• Retrospective Studies
• Rifampin (pharmacology)
• Stents
• Surgical Flaps
• Treatment Outcome