Background
Mycotic abdominal aorta aneurysm (MAAA) is a rare and life-threatening condition.
Because of its rarity, there is a lack of adequately powered studies and consensus
on its treatment and follow up. This study aimed to review the outcomes following
surgical intervention for MAAA in a single tertiary centre and to formulate a management
protocol based on available evidence and expert opinion.
Materials and Methods
Data were collected by retrospective review of case records of all patients who underwent
repair of MAAA in a single tertiary referral centre from 2001 to 2018. Demographic,
clinical and outcome data were analysed and compared with previously published series
in the literature. A management protocol was formulated based on available literature
which was then reviewed and modified as per expert opinion from multidisciplinary
discussions.
Results
Seventeen patients underwent repair of MAAA during the study period including 4 Open
repairs, 4 surgeon modified fenestrated endovascular aortic aneurysm repairs (SM FEVAR)
and 9 endovascular aortic aneurysm repairs (EVAR). One-year overall survival was 94.1%,
3-year survival was 81.8% and 5-year survival was 75.0%. The infection-free survival
at 1, 3, and 5 years was 87.5%, 81.8% and 62.5%, respectively. The overall survival
and infection-free survival curves for Open repair, EVAR and SM FEVAR when compared
using Log Rank (Mantel-Cox) test and did not show any statistically significant difference.
Conclusions
Management of MAAA with selective use of open or endovascular repair, in combination
with appropriate long-term antibiotic therapy, can achieve acceptable outcomes. The
proposed protocol can aid as a guiding document for the management of MAAA but needs
taking into consideration individual patient variability and local expertise.
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Article info
Publication history
Published online: January 25, 2021
Accepted:
December 16,
2020
Received in revised form:
December 7,
2020
Received:
November 20,
2020
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
