Cho JooHyun, Bang Jung Hee, Jeong Sang Seok, Yi Junghoon, Yoon Sung Sil, Cho Kwangjo
Department of Thoracic and Cardiovascular Surgery, Dong-A University College of Medicine, Busan, Korea.
Korean J Thorac Cardiovasc Surg. 2020 Dec 5;53(6):353-360. doi: 10.5090/kjtcs.20.068.
Most abdominal aortic aneurysms are degenerative atherosclerotic aneurysms. Inflammatory or infected abdominal aortic aneurysms, which show a slightly different clinical course, are rarely encountered in clinical settings. Therefore, we aimed to investigate the clinical course of these variants of abdominal aortic aneurysms.
This retrospective study included 32 patients with atypical inflammatory or infected abdominal aortic aneurysms who underwent emergent graft replacement between November 1997 and December 2017. Patients were followed up at the outpatient clinic for a mean period of 4.9±6.9 years. We analyzed the patients' clinical course and compared it with that of patients with atherosclerotic abdominal aortic aneurysms.
There was 1 surgical mortality (3.0%) in a case complicated by aneurysmal free rupture. In 2 cases of infected abdominal aortic aneurysms, anastomotic complications developed immediately postoperatively. During the follow-up period, 10 patients (30%) developed graft complications, and 9 of them underwent reoperations; of these, 2 patients (22.2%) died of postoperative complications after the second operation, whereas 2 patients survived despite graft occlusion.
Patients with inflammatory abdominal aneurysms frequently develop postoperative graft complications requiring secondary surgical treatment, so they require close mandatory postoperative follow-up.
大多数腹主动脉瘤是退行性动脉粥样硬化性动脉瘤。炎症性或感染性腹主动脉瘤的临床病程略有不同,在临床环境中很少见。因此,我们旨在研究这些腹主动脉瘤变体的临床病程。
这项回顾性研究纳入了1997年11月至2017年12月期间接受急诊移植物置换的32例非典型炎症性或感染性腹主动脉瘤患者。患者在门诊平均随访4.9±6.9年。我们分析了患者的临床病程,并将其与动脉粥样硬化性腹主动脉瘤患者的病程进行了比较。
1例合并动脉瘤游离破裂的病例出现1例手术死亡(3.0%)。2例感染性腹主动脉瘤患者术后立即出现吻合口并发症。在随访期间,10例患者(30%)出现移植物并发症,其中9例接受了再次手术;其中,2例患者(22.2%)在第二次手术后死于术后并发症,而2例患者尽管移植物闭塞仍存活。
炎症性腹主动脉瘤患者术后常出现需要二次手术治疗的移植物并发症,因此需要严格的术后密切随访。