Surgical outcome of infectious aneurysm of the abdominal aorta with or without SIRS

The surgical outcome of infectious abdominal aortic aneurysms was evaluated based on the preoperative presence or absence of systemic inflammatory res ponse syndrome (SIRS). Nine patients were divided into two groups according to the criteria for SIRS such as body temperature, heart rate, respiratory rate, and white blood cell count. In the group with SIRS, rupture and impe nding rupture of aneurysms occurred in three of the four patients (75%). Al l aneurysms were resected with a small part as a remnant; two in situ and t wo extraanatomic reconstructions were performed. Three patients died after surgery: one after in situ (cerebral infarction) and two after extraanatomi c reconstruction (sepsis and multiple organ failure). In the group without SIRS, closed en bloc resection in two patients and resection of the aneurys m with a small part as a remnant in three patients were performed. In situ reconstruction in all patients and omentum wrapping in two patients were pe rformed. One of the five patients died of massive hematemesis 70 days after surgery. The overall mortality rate was 75% in the group with SIRS versus 20% in the group without SIRS. The surgical outcome of infectious abdominal aortic aneurysm depends upon the severity of underlying infection. A possi bility exists that SIRS is a useful indicator for predicting the surgical o utcome of patients. (C) 2001 The International Society for Cardiovascular S urgery. Published by Elsevier Science Ltd. All rights reserved.