INFECTED ABDOMINAL AORTIC-ANEURYSM - IN-SITU REPLACEMENT WITH CRYOPRESERVED ARTERIAL HOMOGRAFT

Infected aortic aneurysms are a rare (1-3% of al abdominal aortic aneu rysms) but Life-threatening disease, At present controversy continues about the specific diagnosis and the best surgical management. We pres ent one case of infected aortic aneurysm treated with in situ reconstr uction with cryopreserved arterial homograft. He was a 50-year-old man with recent history of pneumococcal meningitis who is readmitted beca use he suffered a stroke and during physical examination a pulsatile a bdominal mass was discovered. Blood cultures were done and the result was repeatedly negative. Radiological studies were performed: the abdo minal CT scanning showed a non ruptured 5 cm infrarenal aortic aneurys m with irregular wall and in the aortography it appeared eccentric, mu ltilobulated with a clear neck in an otherwise normal size aorta but w ith some arteriosclerotic lesions. The diagnosis of infected aneurysm was suspected and the patient received antibiotic therapy and was oper ated on: aneurysm resection with wide debridement of surrounding tissu es and in situ aortic replacement with aortobifemoral cryopreserved ar terial homograft. Cultures of the aneurysm wall and contents were nega tive but aneurysm wall biopsy suggested an infected aortic aneurysm. T he postoperative course was uneventful and antibiotics were continued for 6 weeks. The patient is doing well 7 months after surgery without signs of recurrent infection and normal appearance of the cryopreserve d arterial homograft, We conclude that specific diagnosis of infected aortic aneurysms is essential for correct treatment but may be difficu lt, in these cases a history of infection supported by radiologic find ings and aneurysm wall biopsy are of great value. Cryopreserved arteri al homografts constitute a good alternative to prosthetic grafts for i n situ reconstructions in the treatment of infected aortic aneurysms, decreasing the risk of re-infection or septic complications.