MYCOTIC AORTIC ANEURYSM - REPRESENTATIVE CASES AND LITERATURE DATA f.meyer@med.ovgu.de

PE050

MYCOTIC AORTIC ANEURYSM - REPRESENTATIVE CASES AND LITERATURE DATA

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Germany

Poster Exhibition only

Mycotic aortic aneurysm (MAA) is a rare life-threatening condition. Therapeutic options are an open surgical resection (OR) with prosthesis implantation and endovascular aortic repair (EVAR).

Presentation of therapeutic decisions illustrated by clinical cases and discussion of current medical scientific literature.

- Cases: 1. An emergency OR performed in a 74-years-old female with a contained rupture of an abdominal aortic aneurysm (AAA) showed an MAA. A xenograft was, therefore, implanted. Ultimately, comorbidities led to her natural death. 2. A 79-years old male with an MAA as the focus of a Salmonella sepsis underwent EVAR using implantation of a stentgraft. Correct graft placement and adequate perfusion were proven. On postoperative day 7, the patient was discharged with long-term antibiotic therapy. 3. A 63-years old male with a contained rupture of an AAA and psoas muscle abscess underwent emergency surgery with OR and implantation of a xenograft. On postoperative day 12, he was discharged with long-term antibiotic therapy. - Literature data: An analysis of 21 studies (2,433 patients) showed a better short-term (3-months) survival using EVAR with 96% (OR, 74%). 5-year-survival rates are similar (EVAR: 57-79.7%, OR: 60%). Most common strains were Salmonella (26.3%) and Staphylococcus aureus (13.9%) - negative cultures, 37.4%. Risk factors are higher age, male gender and comorbidities. A prolonged antibiotic therapy of >6 months improved the outcome.

The treatment of MAA requires an individualized approach, as both OR and EVAR exhibit similar long-term outcomes but distinct early complication rates. Long-term antibiotic therapy appears crucial to support best patient outcome.