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Original Articles: Adult Cardiac

In Situ Replacement for Mycotic Aneurysms on the Thoracic and Abdominal Aorta Using Rifampicin-Bonded Grafting and Omental Pedicle Grafting

^a Department of Cardiovascular Surgery, Hiroshima City Asa General Hospital, Hiroshima, Japan
^b Department of Surgery, Hiroshima University, Hiroshima, Japan

Accepted for publication July 18, 2011.

^_* Address correspondence to Dr Uchida, Department of Surgery, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan (Email: uchidacv{at}hiroshima-u.ac.jp).

Background: The objective of this report is to discuss the efficacy of in situ replacement for treating mycotic aneurysm, particularly using rifampicin-bonded grafts and omental pedicle grafts, on the basis of our 7 years of experience.

Methods: Between December 2003 and December 2010, we performed surgical treatments in 23 patients (for the thoracic aorta in 6 patients, for the thoracoabdominal aorta in 8 patients, and for the abdominal aorta in 9 patients; 7 emergency, 10 urgent, and 6 elective operations) with mycotic aneurysm by using rifampicin-bonded grafting and omental pedicle grafting.

Results: One patient died in hospital because of local recurrent infection. One patient required an additional operation on another aortic site, and 3 patients had spinal cord injuries (2 transient and 1 permanent). Overall survival at 5 years was 95%, and the rate of freedom from aortic events at 5 years was 86%.

Conclusions: In situ replacement using rifampicin-bonded grafting and omental pedicle grafting is effective for treating mycotic aneurysms of the thoracic and abdominal aorta.

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Invited Commentary

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Ann. Thorac. Surg. 2012 93: 442. [Extract] [Full Text] [PDF]

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				G. Dimitrakakis, U. O. von Oppell, and A. A. Azzu eComment. Mycotic aortic aneurysms: a real challenge for the cardiac surgeon Interact CardioVasc Thorac Surg, January 1, 2013; 16(1): 83 - 84. [Full Text] [PDF]

				K. Lachapelle Invited Commentary Ann. Thorac. Surg., February 1, 2012; 93(2): 442 - 442. [Full Text] [PDF]