The Annals of Thoracic Surgery, Vol 30, 160-163, Copyright © 1980 by The Society of Thoracic Surgeons
Repair of mycotic aneurysms of the aorta involving the aortic valve
EP Todd, SG Hubbard, JV Zeok, JR Utley, MR Jones, DL Vine and JS Cole
This report summarizes our successful management of 6 patients who
underwent repair of mycotic aneurysms of the ascending aorta within a
four-year period. Repairs have been successful despite involvement of as
much as two-thirds of the circumference of the aortic valve annulus,
involvement of the origin of the right coronary artery, and development of
heart block. Three patients required surgical intervention because of
hemodynamic decompensation before they had completed antibiotic therapy for
endocarditis. In 3 patients, the aneurysm was buttressed with the valve
skirt so that aneurysm repair and valve replacement were accomplished in
continuity. In 2 patients, the aneurysm was repaired separately and the
valve seated on the repair. In 1 patient, a large defect between the left
and right coronary arteries was repaired with a woven Dacron patch secured
to the valve skirt. The valve was seated to the left ventricle and the
graft to the aorta. There were no operative or postoperative deaths. Our
data suggest that mycotic aneurysms of the aortic annulus can be
successfully repaired despite extensive damage.
