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Thorac Cardiovasc Surg 2013; 61(07): 597-599
DOI: 10.1055/s-0032-1322618
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Endovascular Repair of Mycotic Aneurysm of the Descending Thoracic Aorta: Diagnostic and Therapeutic Dilemmas—Two Case Reports with 1-Year Follow-Up

Ivan Marjanovic
1   Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
,
Momir Sarac
1   Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
,
Aleksandar Tomic
1   Clinic for Vascular and Endovascular Surgery, Military Medical Academy, Belgrade, Serbia
,
Mihailo Bezmarevic
2   Clinic for General Surgery, Military Medical Academy, Belgrade, Serbia
› Author Affiliations
Further Information

Publication History

08 March 2012

06 April 2012

Publication Date:
06 December 2012 (online)

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Abstract

A mycotic aneurysm of the thoracic aorta is a rare diagnosis with high mortality. We present two cases of endovascular reconstruction of mycotic descending thoracic aorta. Specific or nonspecific bacterial or other infectious agent in serial samples of blood, urine, cerebrospinal fluid, and pleural puncture was not detected in the first case, but we found in sputum sample Mycobacterium tuberculosis in the second patient. We empirically began by administering broad-spectrum intravenous antibiotics in the first case, with preoperative antibiotic prophylaxis and antituberculotic drugs therapy in the second case, and continued with the same medication for 4 months after endovascular repair. Control computed tomographic scans 6 months after reconstruction showed no endoleak in both patients. Repair of mycotic descending thoracic aortic aneurysms by endoluminal stent graft is reasonable alternative to open surgical intervention. A broad-spectrum antibiotic therapy has a high significance in the treatment of patients with mycotic aneurysm.

Keywords

endovascular graft - descending thoracic aorta - mycotic aneurysm - pathogens - antibiotics
 

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