Pasic M, Carrel T, Vogt M, von Segesser L, Turina M
Clinic for Cardiovascular Surgery, University Hospital Zurich, Switzerland.
Eur J Vasc Surg. 1992 Jul;6(4):419-23. doi: 10.1016/s0950-821x(05)80291-9.
Twenty-seven patients with mycotic aneurysms of the aorta and its major branches were operated on between 1969 and 1991. There were 24 males and three females ranging in age from 6 to 84 years (mean age for adults 63 years). Sixteen of the 27 (59%) aneurysms were ruptured and in situ repair was undertaken in 20 (74%) patients. The mean follow-up was 5.8 years (range: 8 months to 16 years). Four patients (15%) died during the hospital stay and 23 survived. There were eight late deaths, two of which were a direct result of the aneurysm. The estimated 1- and 5-year survival rates were 62 and 36%, respectively. Extra-anatomic reconstruction is the method of choice for the majority of patients with mycotic aneurysm of the infrarenal abdominal aorta and iliac arteries. In situ repair after an extensive debridement of the aneurysmal wall and all infected tissue combined with antibiotic therapy is a satisfactory method of treating mycotic aneurysms of other locations, and for a highly selected group of patients with infrarenal mycotic aortic aneurysms.
1969年至1991年间，对27例主动脉及其主要分支的霉菌性动脉瘤患者进行了手术。其中男性24例，女性3例，年龄在6岁至84岁之间（成人平均年龄63岁）。27例动脉瘤中有16例（59%）破裂，20例（74%）患者进行了原位修复。平均随访时间为5.8年（范围：8个月至16年）。4例患者（15%）在住院期间死亡，23例存活。有8例晚期死亡，其中2例直接死于动脉瘤。估计1年和5年生存率分别为62%和36%。对于大多数肾下腹主动脉和髂动脉霉菌性动脉瘤患者，解剖外重建是首选方法。对动脉瘤壁和所有感染组织进行广泛清创后结合抗生素治疗的原位修复，是治疗其他部位霉菌性动脉瘤以及一小部分经过严格筛选的肾下霉菌性主动脉瘤患者的令人满意的方法。
