Stellmes Arno, Von Allmen Regula, Derungs Urs, Dick Florian, Makaloski Vladimir, Do Dai-Do, Schmidli Jürg, Czerny Martin
Department of Cardiovascular Surgery, University Hospital Berne, Berne, Switzerland.
Interact Cardiovasc Thorac Surg. 2013 Apr;16(4):459-64. doi: 10.1093/icvts/ivs539. Epub 2013 Jan 3.
To evaluate thoracic endovascular aortic repair (TEVAR) as emergency therapy despite suspected aortic infection.
Within a 5-year period, we treated 6 patients with a strategy of primary TEVAR despite suspected aortic infection in patients with symptomatic or already ruptured thoracic aortic pathology.
In-hospital mortality was 16.7%. The reason for death was septic multiorgan failure. During follow-up, 2 patients were converted to secondary open surgery in a stable elective setting. The median follow-up was 42.5 months. All surviving patients are not receiving continuing antibiotic therapy. Freedom from infection is 100% to date.
TEVAR as emergency therapy despite suspected aortic infection is feasible and may well serve as a definite treatment option in selected cases. As recurring infection cannot be entirely excluded, life-long clinical and morphological surveillance remains mandatory.
评估尽管怀疑存在主动脉感染但仍将胸主动脉腔内修复术（TEVAR）作为紧急治疗手段的效果。
在5年时间里，我们对6例有症状或已破裂的胸主动脉病变且怀疑存在主动脉感染的患者采用了初次TEVAR治疗策略。
住院死亡率为16.7%。死亡原因是感染性多器官功能衰竭。在随访期间，2例患者在病情稳定的择期情况下转为二次开放手术。中位随访时间为42.5个月。所有存活患者均未接受持续抗生素治疗。迄今为止，无感染率为100%。
尽管怀疑存在主动脉感染，但将TEVAR作为紧急治疗手段是可行的，并且在某些特定病例中很可能作为一种确定性的治疗选择。由于不能完全排除复发性感染，终身的临床和形态学监测仍然是必要的。
