In Situ Polytetrafluoroethylene Graft Bypass for Primary Infected Aneurysm of the Infrarenal Abdominal Aorta

Tae-Won Kwon; Hyang-Kyoung Kim; Ki-Myung Moon; Yong-Pil Cho; Sang-Jun Park
July 2010
World Journal of Surgery;Jul2010, Vol. 34 Issue 7, p1689
Academic Journal
Reinfection is a major issue of surgical treatment for patients with infected abdominal aortic aneurysm (AAA). The present report describes outcomes after use of our procedure for treating patients with infected aneurysm of the infrarenal abdominal aorta. The procedure involved an in situ polytetrafluoroethylene (PTFE) graft bypass and omental wrapping of the graft. The procedure was used regardless of the presence of Gram-stain-positive pus or tissue or the type of pathogen identified. We retrospectively reviewed nine consecutive patients with primary infected aneurysms of the infrarenal abdominal aorta treated from June 2001 to August 2006 at the Asan Medical Center, Seoul, Korea. Diagnosis was based on preoperative abdominopelvic CT scans. Treatment involved removal of all infected tissue, including infected aorta tissue, in situ PTFE graft reconstruction, and wrapping of the graft with retrocolically transposed great omentum. Sensitive antibiotics were administered before and after the operation. In all cases, aneurysms were the result of aortitis and aortic wall perforation, and presented as aortic pseudoaneurysms with rupture. The pathogens identified were Salmonella non-typhi ( n = 4), Klebsiella pneumoniae ( n = 2), Streptococcus pneumoniae ( n = 1), Citrobacter freundii ( n = 1), and Brucella abortus ( n = 1). There was no infection-related morbidity or mortality during a median follow-up period of 49 months. Surgical treatment comprising complete removal of all infected tissue, in situ PTFE graft reconstruction, and omental wrapping of the graft was effective in treating infected AAA. Key adjunct procedures were a precise preoperative diagnosis using abdominopelvic CT scans, and pre- and postoperative sensitive antibiotic treatment.


Related Articles

  • Abdominal Aortic Aneurysm. Pasic, Miralem; Turina, Marko // New England Journal of Medicine;1/4/96, Vol. 334 Issue 1, p26 

    An image of an aneurysm of the infrarenal aorta from a cross-sectional computed tomographic scan of the abdomen in an 85-year-old man is presented.

  • Ruptured Abdominal Aortic Aneurysm. Gervais, Debra A.; Whitman, Gary J. // New England Journal of Medicine;1/4/96, Vol. 334 Issue 1, p27 

    An image of a ruptured abdominal aortic aneurysm from a computed tomography scan of the abdomen of an 85-year-old man is presented.

  • Evolution of healthy thoracic aortic segment diameter during follow-up of patients with aortic aneurysm or dissection: a magnetic resonance imaging study. Benachenhou, K.; Azarnouch, K.; Filaire, M.; Ravel, A.; Boyer, L.; Garcier, J. M. // Surgical & Radiologic Anatomy;Apr2005, Vol. 27 Issue 2, p142 

    We studied the normal evolution over time of the diameter of the healthy descending aorta in patients suffering from aneurysm or dissection of the ascending aorta, in order to anticipate potential complications of endoprosthetic treatment in this aortic segment. During their follow-up (average...

  • Sealed rupture of abdominal aortic aneurysms: CT features in 6 patients and a review of the literature. Apter, S.; Rimon, U.; Konen, E.; Erlich, Z.; Guranda, L.; Amitai, M.; Portnoy, O.; Gayer, G.; Hertz, M. // Abdominal Imaging;Feb2010, Vol. 35 Issue 1, p99 

    Purpose: To assess the CT features of sealed rupture of abdominal aortic aneurysm. Patients and Methods: We reviewed the CT scans of six index cases obtained over a 3 year period with a sealed rupture of an abdominal aortic aneurysm and those reported in the literature...

  • False Positive Computed Tomography Findings in Aortic Dissection. Shanmugam, Ganesh; Mckeown, June; Bayfield, Matthew; Hendel, Nicholas; Hughes, Clifford // Heart, Lung & Circulation;Jun2004, Vol. 13 Issue 2, p184 

    Dissection is the commonest acute catastrophe involving the aorta. Computed tomography (CT) is increasingly used in evaluating patients with suspected aortic dissection. Occasionally normal anatomic structures may be misconstrued as pathologic due of lack of familiarity with anatomical...

  • Risk factors for secondary dilatation of the aorta after acute type A aortic dissection Immer, Franz F.; Hagen, Urs; Berdat, Pascal A.; Eckstein, Friedrich S.; Carrel, Thierry P. // European Journal of Cardio-Thoracic Surgery;Apr2005, Vol. 27 Issue 4, p654 

    Abstract: Objectives: Prompt diagnosis of subsequent dilatation of the dissected aorta is crucial to reduce late mortality in these patients. This study focuses on risk factors for dilatation of the aorta after type A aortic dissection (AADA) affecting a normal-sized or slightly dilated aorta....

  • Repair of an Abdominal Aortic Aneurysm with a Remarkably Dilated Meandering Artery: Report of a Case. Shun-ichiro Sakamoto; Shigeo Yamauchi; Hiromasa Yamashita; Hajime Imura; Yuji Maruyama; Masami Ochi; Kazuo Shimizu // Surgery Today;Feb2007, Vol. 37 Issue 2, p133 

    Abstract??A 73-year-old man on dialysis for chronic renal dysfunction was referred to our hospital for surgical treatment of an abdominal aortic aneurysm (AAA). Preoperative angiography showed a remarkably developed meandering artery branching from the inferior mesenteric artery (IMA). The...

  • Primary sarcoma of an abdominal aortic aneurysm. Defawe, O. D.; Thiry, A.; Lapiere, C. M.; Limet, R.; Sakalihasan, N. // Abdominal Imaging;Jan/Feb2006, Vol. 31 Issue 1, p117 

    Primary tumors of the aorta are extremely rare and the diagnosis is made most often after surgery or autopsy. Because clinical symptoms of abdominal sarcoma are similar to those of occlusive or aneurysmal disease, aortic sarcomas are frequently mistaken for these lesions. The imaging findings...

  • Potential role of omental wrapping to prevent infection after treatment for infectious thoracic aortic aneurysms. Yamashiro, Satoshi; Arakaki, Ryoko; Kise, Yuya; Inafuku, Hitoshi; Kuniyoshi, Yukio // European Journal of Cardio-Thoracic Surgery;Jun2013, Vol. 43 Issue 6, p1177 

    OBJECTIVES Postoperative infection control is one of the most important issues for infected aortic aneurysms, and the methods of preventing recurrent infection remain controversial. We previously reported that omental flaps could prevent or reduce the occurrence of infection after implanting an...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics