SURGICAL-TREATMENT OF INFECTED AORTIC-ANEURYSM

BACKGROUND: We report results of infected aortic aneurysms treated by a single group over 20 years. METHODS: Retrospective review. RESULTS: Seventeen patients were treated, 10 with infrarenal and 7 suprarenal i nfections. All had abdominal/back pain, 88% were febrile, 71% had leuk ocytosis, and 24% were hemodynamically unstable. The most common respo nsible organism was Staphylococcus aureus (29%) followed by Salmonella organisms (24%). All suprarenal infections were gram-positive organis ms. Infrarenal infections were treated with preliminary axillofemoral bypass followed by aortic resection. Suprarenal infections were treate d with either in situ prosthetic graft or patch repairs. Operative sur vival was 90% for infrarenal and 57% for suprarenal infections. Operat ive deaths occurred in the setting of overwhelming sepsis and/or sever e preoperative hemodynamic instability. There was no limb loss, renal failure, or intestinal ischemia. Late deaths occurred in 4 patients at 1.3 to 6.3 years postoperatively and were unrelated to their aortic r epairs. Nine patients remain alive with a median follow-up of 2 years, There have been no late aortic or graft infections. CONCLUSIONS: In t he absence of hemodynamic instability and uncontrolled sepsis, infecte d aortic aneurysms can be successfully repaired with durable results. (C) 1998 by Excerpta Medica, Inc.