Mycotic aneurysms of the suprarenal abdominal aorta: Prolonged survival after in situ aortic and visceral reconstruction

Research output: Contribution to journalArticlepeer-review

45 Scopus citations

Abstract

Necrotizing infection of the arterial wall causes rupture and false ("mycotic") aneurysm formation, with a very poor prognosis if untreated. Cure can be achieved by surgical drainage and debridement, with restoration of arterial continuity through uncontaminated tissues. The dilemma of applying these principles to the treatment of mycotic aneurysms of the suprarenal aorta is that no remote or extraanatomic routes are available to maintain perfusion to the viscera. We report the first case of Klebsiella suprarenal mycotic aortic aneurysm successfully treated with in situ prosthetic reconstruction of the aorta and visceral arteries, and we have reviewed the 21 other suprarenal mycotic aortic aneurysms reported in the English-language literature. Repair was performed in 20 of the 22 cases, with in situ prosthetic reconstruction performed in 18. Prolonged survival has been achieved in 16 patients after in situ repair. No long-term survival has been reported after extraanatomic reconstruction of the aorta and visceral arteries in patients with such aneurysms. We conclude that in situ prosthetic reconstruction, accompanied by thorough drainage and debridement, prolonged parenteral antibiotic therapy, and permanent suppressive oral antibiotics, offers the best chance for survival in these patients.

Original languageEnglish (US)
Pages (from-to)635-641
Number of pages7
JournalJournal of Vascular Surgery
Volume10
Issue number6
DOIs
StatePublished - Dec 1989

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Mycotic aneurysms of the suprarenal abdominal aorta: Prolonged survival after in situ aortic and visceral reconstruction'. Together they form a unique fingerprint.

Cite this