In Situ Repair of a Mycotic Suprarenal Aortic Aneurysm Using a Cryopreserved Aortic Homograft and Visceral Debranching in a Patient with Spondylodiscitis and Left Psoas Muscle Abscess

Abstract

We present a patient with ruptured suprarenal aortic aneurysm, involving origins of visceral and renal arteries. Associated spondylodiscitis and left psoas muscle abscess were also diagnosed. The patient was initially treated with antibiotics. Diagnostic survey showed progression of the aneurysm diameter and enlargement of the psoas muscle abscess. Surgical treatment using a cryopreserved aortic homograft with debranching of visceral arteries was performed. Different modalities of surgical repair within the infected aortic segment and the rationale for usage of cryopreserved homografts are considered. The importance of optimal timing for surgery is emphasized as well.

Aortic Infection with Visceral Artery Involvement in the Endovascular Era: Treatment Options

“…Cultures were positive for Staphylococcus species and Propionibacterium species. No recurrence of infection or other complications were evident at a 7-month follow-up [91].…”

“…For these reasons, over the years, many authors have reported a plethora of alternative, less invasive, hybrid, or endovascular approach. Here, several cases of infectious aneurysms involving visceral branches are reported, with particular attention to treatment strategies and relative results [80,81,[87][88][89][90][91][92][93][94].…”

“…Over the years, despite the emerging role of endovascular surgery, open reconstruction has continued to perform with favorable results as in a very interesting East-European experience [91]. Petrunic et al described a very rare and interesting case of patient with ruptured suprarenal aortic aneurysm, involving origins of visceral and renal arteries, associated with spondylodiscitis and an abscess of the left psoas muscle.…”