초록접수 현황
| 19F-287 | 포스터 발표 |
Long Term Surgical Result of Mycotic Aneurysm: A Review of 18 Cases
Su Chan Lim, Suk Ho Sohn, Jae Woong Choi, Kyung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
Purpose : Mycotic aneurysm in thoracic and abdominal aorta is a rare and life-threatening disease which requires immediate intervention including antibiotic therapy and surgical treatment. We evaluated long-term clinical outcomes of aortic surgery for mycotic aneurysm.
Methods : From 2005 to 2018, 18 patients (67.2±17.7 years) underwent the aortic surgery for mycotic aneurysm. Microbial studies of intraoperative specimens confirmed their final diagnoses. The aneurysms were located in ascending aorta (n=1, 5.6%), aortic arch (n=7, 38.9%), descending thoracic aorta (n=6, 33.3%), and abdominal aorta (n=9, 50.0%). Mean follow-up duration was 27.3 ± 66.5 months.
Results : Operative mortality occurred in 2 patients (11.1%). The causes of death were septic shock and low cardiac output. Postoperative morbidity occurred in 14 patients including atrial fibrillation (n=5), bleeding reoperation (n=2). Ten patients (55.6%) had concealed rupture or penetrating ulcer in preoperative CT findings. The diameter of the aneurysm was 46.5mm (range 24.7 to 75.0). The predominant microorganisms were Staphylococcus aureus (n=4, 22.2%) and Klebsiella pneumoniae (n=3, 16.7%). The length of hospital stay was 36.1 days (range 11 to 98). Overall survival at 3 and 5 years were 50.0% and 33.3%, respectively. During the follow-up (mean 27.3 months, 0-96), 6 patients died, 5 of them had rupture in preoperative CT (83.3%), and 6 patients were confirmed alive.
Conclusion : Mycotic aneurysm of thoracic and abdominal aorta is uncommon but fatal condition despite adequate surgical intervention. The operative risk increases if the preoperative CT revealed the rupture of the aortic lesion. Early detection before rupture of the aneurysm may improve the clinical outcomes.
Methods : From 2005 to 2018, 18 patients (67.2±17.7 years) underwent the aortic surgery for mycotic aneurysm. Microbial studies of intraoperative specimens confirmed their final diagnoses. The aneurysms were located in ascending aorta (n=1, 5.6%), aortic arch (n=7, 38.9%), descending thoracic aorta (n=6, 33.3%), and abdominal aorta (n=9, 50.0%). Mean follow-up duration was 27.3 ± 66.5 months.
Results : Operative mortality occurred in 2 patients (11.1%). The causes of death were septic shock and low cardiac output. Postoperative morbidity occurred in 14 patients including atrial fibrillation (n=5), bleeding reoperation (n=2). Ten patients (55.6%) had concealed rupture or penetrating ulcer in preoperative CT findings. The diameter of the aneurysm was 46.5mm (range 24.7 to 75.0). The predominant microorganisms were Staphylococcus aureus (n=4, 22.2%) and Klebsiella pneumoniae (n=3, 16.7%). The length of hospital stay was 36.1 days (range 11 to 98). Overall survival at 3 and 5 years were 50.0% and 33.3%, respectively. During the follow-up (mean 27.3 months, 0-96), 6 patients died, 5 of them had rupture in preoperative CT (83.3%), and 6 patients were confirmed alive.
Conclusion : Mycotic aneurysm of thoracic and abdominal aorta is uncommon but fatal condition despite adequate surgical intervention. The operative risk increases if the preoperative CT revealed the rupture of the aortic lesion. Early detection before rupture of the aneurysm may improve the clinical outcomes.
책임저자: Kyung Hwan Kim
Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
발표자: Su Chan Lim, E-mail : lsc4869@nate.com