Infected thoracoabdominal aortic aneurysms including the major abdominal branches in 4 cases

• Published in: Annals of thoracic and cardiovascular surgery Vol. 14; no. 3; pp. 196 - 199
• Main Authors: Inafuku, Hitoshi, Senaha, Shigenobu, Morishima, Yuji, Nagano, Takaaki, Arakaki, Katsuya, Yamashiro, Satoshi, Kuniyoshi, Yukio
• Format: Journal Article
• Language: English
• Published: Japan 01.06.2008
• Subjects: Adult; Aged; Aged, 80 and over; Aneurysm, Infected - diagnostic imaging; Aneurysm, Infected - microbiology; Aneurysm, Infected - surgery; Anti-Bacterial Agents - therapeutic use; Aortic Aneurysm, Thoracic - diagnostic imaging; Aortic Aneurysm, Thoracic - microbiology; Aortic Aneurysm, Thoracic - surgery; Blood Vessel Prosthesis - adverse effects; Blood Vessel Prosthesis Implantation - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Debridement; Female; Humans; Male; Middle Aged; Polyethylene Terephthalates; Prosthesis-Related Infections - etiology; Prosthesis-Related Infections - prevention & control; Spinal Cord Ischemia - etiology; Spinal Cord Ischemia - prevention & control; Tomography, X-Ray Computed; Treatment Outcome
• ISSN: 1341-1098

We present four cases of infected thoracoabdominal aortic aneurysm (TAAA), including abdominal branches that underwent surgical repair. The mean age of patients at the time of operation was 61+/-18 (range: 39-83) years. The extent of the aneurysm was Crawford type III in 1 case and type IV in the other 3. They all underwent an emergency or urgent operation, which consisted of a debridement of the infected tissue, in situ four-branched Dacron graft replacement, and iodine gauze packing for 48 h followed by omental wrapping of the graft. To prevent postoperative spinal ischemia, intercostal and lumbar arteries were reimplanted under motor-evoked potential (1.25 pairs per patient). There was one (25%) hospital death, but postoperative graft infection did not occur in these present cases during a mean follow-up period of 15+/-43 (1-96) months. Antibiotics were administered intravenously for 8 weeks after the operation, then continued orally for a lifelong period. Postoperatively, paraplegia occurred in one (25%) patient. Our strategy for infected TAAA including major abdominal branches may prevent postoperative graft infection.