Contemporary Single-Center Experience With Aortic Infections

Abstract

BackgroundAortic infections are relatively uncommon pathologies associated with high operative morbidity and mortality. This study aims to report the outcomes of operative aortic infections at our institution and compares clinical outcomes of native aortic tissue and graft infections.MethodsWe quarried our prospectively maintained aortic database and identified patients that underwent operative treatment of aortic infections involving thoracoabdominal and abdominal aorta. Electronic health medical records were then used to retrospectively collect preoperative, intraoperative, and postoperative clinical data and outcomes. The primary end point was all-cause mortality. The χ2 test and Student t tests were used to evaluate statistical significance.ResultsFrom 2009 to 2021, 35 patients (86% men) were operatively treated for native aortic tissue infection (37%) and aortic graft infections (63%). The median age was 67 years (range, 49-83 years). Eight patients (23%) presented with thoracoabdominal aortic infections while 27 (77%) presented with abdominal infections, most of which were infrarenal (69%). Positive blood cultures were present in 17 (49%) cases with Salmonella and Staphylococcus being the most common organisms. Salmonella species were found significantly more in native aortic infections compared to grafts (P = .005) Open repairs were performed in the majority of cases (27/35 or 77%) with 3 endovascular (9%) and 5 hybrid (14%) cases. All-cause mortality was 17% at 90 days and 31% at 1 ear for the cohort. Operative mortality and morbidity were not significantly different between native aortic compared to graft infections (P > .05).ConclusionsDespite recent advances in perioperative care, aortic infections continue to carry significantly high morbidity and mortality. Operative repair outcomes of native aortic infections are comparable to aortic graft infections. BackgroundAortic infections are relatively uncommon pathologies associated with high operative morbidity and mortality. This study aims to report the outcomes of operative aortic infections at our institution and compares clinical outcomes of native aortic tissue and graft infections. Aortic infections are relatively uncommon pathologies associated with high operative morbidity and mortality. This study aims to report the outcomes of operative aortic infections at our institution and compares clinical outcomes of native aortic tissue and graft infections. MethodsWe quarried our prospectively maintained aortic database and identified patients that underwent operative treatment of aortic infections involving thoracoabdominal and abdominal aorta. Electronic health medical records were then used to retrospectively collect preoperative, intraoperative, and postoperative clinical data and outcomes. The primary end point was all-cause mortality. The χ2 test and Student t tests were used to evaluate statistical significance. We quarried our prospectively maintained aortic database and identified patients that underwent operative treatment of aortic infections involving thoracoabdominal and abdominal aorta. Electronic health medical records were then used to retrospectively collect preoperative, intraoperative, and postoperative clinical data and outcomes. The primary end point was all-cause mortality. The χ2 test and Student t tests were used to evaluate statistical significance. ResultsFrom 2009 to 2021, 35 patients (86% men) were operatively treated for native aortic tissue infection (37%) and aortic graft infections (63%). The median age was 67 years (range, 49-83 years). Eight patients (23%) presented with thoracoabdominal aortic infections while 27 (77%) presented with abdominal infections, most of which were infrarenal (69%). Positive blood cultures were present in 17 (49%) cases with Salmonella and Staphylococcus being the most common organisms. Salmonella species were found significantly more in native aortic infections compared to grafts (P = .005) Open repairs were performed in the majority of cases (27/35 or 77%) with 3 endovascular (9%) and 5 hybrid (14%) cases. All-cause mortality was 17% at 90 days and 31% at 1 ear for the cohort. Operative mortality and morbidity were not significantly different between native aortic compared to graft infections (P > .05). From 2009 to 2021, 35 patients (86% men) were operatively treated for native aortic tissue infection (37%) and aortic graft infections (63%). The median age was 67 years (range, 49-83 years). Eight patients (23%) presented with thoracoabdominal aortic infections while 27 (77%) presented with abdominal infections, most of which were infrarenal (69%). Positive blood cultures were present in 17 (49%) cases with Salmonella and Staphylococcus being the most common organisms. Salmonella species were found significantly more in native aortic infections compared to grafts (P = .005) Open repairs were performed in the majority of cases (27/35 or 77%) with 3 endovascular (9%) and 5 hybrid (14%) cases. All-cause mortality was 17% at 90 days and 31% at 1 ear for the cohort. Operative mortality and morbidity were not significantly different between native aortic compared to graft infections (P > .05). ConclusionsDespite recent advances in perioperative care, aortic infections continue to carry significantly high morbidity and mortality. Operative repair outcomes of native aortic infections are comparable to aortic graft infections. Despite recent advances in perioperative care, aortic infections continue to carry significantly high morbidity and mortality. Operative repair outcomes of native aortic infections are comparable to aortic graft infections.