Asian Cardiovasc Thorac Ann 2005;13:11-16
© 2005 Asia Publishing EXchange Ltd
Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection
Yukio Kuniyoshi, MD,
Kageharu Koja, MD,
Kazufumi Miyagi, MD,
Tooru Uezu, MD,
Satoshi Yamashiro, MD,
Katuya Arakaki, MD
Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
For reprint information contact: Yukio Kuniyoshi, MD Tel: 81 98 895 1168 Fax: 81 98 895 1422 Email: kuni9244{at}med.u-ryukyu.ac.jp, Second Department of Surgery, Faculty of Medicine, University of the Ryukyus, 207 Uehara Nishihara-cho, Okinawa 903-0215, Japan.
Nine cases of mycotic thoracic aortic aneurysm were treated surgically between July 1995 and March 2003. The aneurysms were located in the ascending aorta in 1 patient, the descending thoracic aorta in 5, and the thoracoabdominal aorta in 3. Preoperatively, 3 patients were in shock due to rupture of the aneurysm. All patients underwent aneurysmectomy and in-situ graft placement. In 5 patients, the graft was covered with a pedicled omental flap to prevent postoperative graft infection. There were 2 hospital deaths: one patient died of multi-organ failure, and the other died from intrathoracic bleeding. After discharge, one patient died from intrathoracic bleeding 3 months after surgery. These 3 patients had not received omental wrapping. Postoperative graft infection did not occur in the 6 surviving patients during a mean follow-up period of 4.0 ± 3.1 years. It was concluded that covering the prosthetic graft with a pedicled omental flap may help prevent postoperative graft infection and improve the surgical results.
Copyright © 2005 by the Asia Publishing EXchange Ltd.
