Repair of Thoracic and Thoracoabdominal Mycotic Aneurysms and Infected Aortic Grafts Using Allograft

Corvera, Joel S.; Blitzer, David; Copeland, Hannah; Murphy, Daniel; Hess, Philip J.; Pillai, Saila T.; Fehrenbacher, John W.

doi:10.1016/j.athoracsur.2018.04.050

Cited by 23 publications

(15 citation statements)

References 39 publications

(54 reference statements)

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“…Some groups have presented lower rates of recurrent infection and lower morbidity and mortality rates associated with rifampicin-soaked Dacron grafts compared to those with untreated grafts [34,45].…”

Section: Discussionmentioning

confidence: 99%

“…Cryopreserved arterial allografts have the advantage of a higher resistance to infection, with low rates of reinfection. Techniques in cryopreservation have improved in the last decade, possibly contributing to better outcomes of revascularization using these allografts [34,41,50].…”

Section: Discussionmentioning

confidence: 99%

“…Some groups have used specific definitions to delineate mycotic aortic aneurysms, including all of the following: fever or sepsis, abnormal laboratory findings (elevated CRP or white cell count), positive blood cultures, and radiologic studies showing a false aneurysm (with or without stranding), periaortic fluid, or air around the aorta [34]. Common radiologic (CT and MRI) features of MAAs are an irregular aortic wall, a lobulated vascular periaortic mass, and peri-aneurysmal gas/ soft-tissue mass/edema.…”

Section: Diagnosismentioning

confidence: 99%

“…Nuclear medicine studies, including fluorodeoxyglucose-positron emission tomography (FDG-PET) and nuclear gallium scanning, are alternative modalities for evaluating mycotic aortic aneurysms that are becoming increasingly useful. PET-CT testing has a very high sensitivity and both high positive and negative predictive values for aortic graft infection, and also provides important information in the diagnosis of mycotic aneurysms [34].…”

Section: Diagnosismentioning

confidence: 99%

“…Current imaging studies have reported variable sensitivities regarding FDG-PET. Most series have published specificities of 88-100% for 18F-FDG PET and PET-CT for diagnosing active inflammation in arteritis (Figure 1) [34][35][36].…”

Section: Diagnosismentioning

confidence: 99%

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Mycotic Aortic Aneurysms

Bernal¹,

Requejo²,

Ribes³

et al. 2020

Aortic Aneurysm and Aortic Dissection

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Various studies have evaluated the possibilities of surgical repair of mycotic aortic aneurysms (MAAs). Open surgical repair has usually been accepted as the gold standard treatment of MAAs. The main concern is that it carries a significant mortality risk, varying from 20 to 40% in different studies, and a 5-year survival rate of 30-50%. The largest study of open surgical treatment of mycotic aortic aneurysms (MAA) was published in 2018, and consisted of 187 patients of whom open repairs were performed in 107 patients (57%). Most of the endovascular series conclude that endovascular treatment of MAA is feasible and an acceptable alternative treatment to open repair. Although endovascular repair might be a durable option for some patients, late infection-associated complications frequently occur and are often lethal. An overall analysis of this rare pathology, its different diagnostic modalities, treatment options, and prognosis are presented and discussed in this chapter.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

Section: Diagnosismentioning

confidence: 99%

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