https://scholars.lib.ntu.edu.tw/handle/123456789/474908
標題: | Primary infected aortic aneurysm: Clinical presentation, pathogen, and outcome | 作者: | Lin C.-H. RON-BIN HSU |
關鍵字: | Infected aortic aneurysm; Outcome; Pathogen; Surgery | 公開日期: | 2014 | 出版社: | Republic of China Society of Cardiology | 卷: | 30 | 期: | 6 | 起(迄)頁: | 514-521 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Purpose: Infected aneurysm of the aorta and adjacent arteries is rarely occurring and can be fatal without surgical intervention. Within the medical community, the most efficacious treatment strategy to address infected aortic aneurysm remains controversial. In this study, we have reviewed our treatment experience with 109 patients. Methods: We included in our study all consecutive patients treated for primary infected aortic aneurysm at our facility between 1995 and 2011. Aneurysm-related mortality was defined as the presence of in-hospital and late mortality related to infection or postoperative complications. Results: The median patient age was 72 years (range, 35-88), and 87 (80%) were male. Pathogen was isolated in 101 patients, and the most common microorganism identified was non-typhoid Salmonella in 61 (60%), followed by Staphylococcus aureus in 16 (16%) and Streptococci species in 7 (7%). Eighty-five (78%) patients underwent surgical treatment. Surgery included open repair with in-situ graft replacement in 77 (71%) and endovascular repair in 8 (7%). The aneurysm-related mortality rate was 67% in medically treated and 21% in surgically treated patients, with a median follow-up duration of 31.5 months (range 1-189). Additionally, risk factors for aneurysmrelated mortality included old age, chronic lung disease, psoas muscle abscess, short duration of preoperative antibiotics, no operation, and probably endovascular repair. Conclusions: Non-typhoid Salmonella was the most common pathogen found in our study group patients with infected aortic aneurysm. It appears that prolonged preoperative antibiotic treatment followed by open in-situ graft replacement remains the preferred and most effective treatment strategy. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84923032801&doi=10.6515%2fACS20140630A&partnerID=40&md5=7ed1820756173301d2b8c3915200c609 https://scholars.lib.ntu.edu.tw/handle/123456789/474908 |
ISSN: | 1011-6842 | DOI: | 10.6515/ACS20140630A | SDG/關鍵字: | ceftriaxone; abdominal aorta; adult; aged; antibiotic therapy; aorta aneurysm; aorta arch; Article; cardiovascular infection; cardiovascular mortality; chronic lung disease; cohort analysis; concurrent infection; endovascular aneurysm repair; false aneurysm; female; follow up; human; iliac artery; major clinical study; male; mortality; nonhuman; observational study; postoperative complication; preoperative treatment; primary infected aortic aneurysm; psoas abscess; recurrent infection; retrospective study; saccular aneurysm; Salmonella; Staphylococcus aureus; Streptococcus; thoracic aorta; treatment duration; very elderly |
顯示於: | 醫學系 |
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