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Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)

Received: 23 October 2018    Accepted: 6 December 2018    Published: 24 January 2019
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Abstract

Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to evaluate the results of the surgery. Materials and Methods: This was a descriptive retrospective study over a 12-years period from December 2005 to February 2018. Results: The total number of our series was 12 cases. The average age at the time of surgery was 37 years old [17-83 years]. There was no predominance of sex. There was a notion of smoking in 3 cases / 12. There was no concept of addiction. Four out of 12 cases had a known concept of heart disease with mitral insufficiency, aortic insufficiency, and complete atrioventricular block. A patient presented in this antecedents a notion of syphilis treated and declared cured. The clinical symptomatology was made of fever in 4 cases out of 12, pain in 11 cases out of 12 with 3 cases of intermittent claudication. The clinical examination had shown a swelling with vascular characters in 11 cases out of 12. Two out of 12 patients had signs of acute limb ischemia. The arterial echodoppler was performed in 11cases out of 12 which had made the diagnosis. The angioscan was performed in 8 cases and showed 4 cases of sacciform aneurysms. All patients benefited from open surgery. The exploration showed 9 cases of false aneurysms with signs of local infection in 5 cases. Flattening with excision of the infected tissues was performed in all cases. The restoration of vascular continuity was immediate in all cases by end-to-end direct anastomosis in 8 cases, 2 cases of extra-anatomical bypass using a dacron tube and two cases of anatomical bypass using the saphenous vein in situ. Early complications were dominated by 2 cases of acute limb ischemia, 2 cases of superficial surgical site infection, 1 case of deep surgical site infection, 1 case of false aneurysm of a common femoral artery and 1 case of hematoma. Follow-up was performed in all patients with an average delay of 14 months [1-60]. There were 1 case of operative mortality and 2 cases of late mortality.

Published in Cardiology and Cardiovascular Research (Volume 3, Issue 1)
DOI 10.11648/j.ccr.20190301.11
Page(s) 1-5
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Mycotic Aneurysms, Surgery, Senegal

References
[1] Chen IM, Chang H., Hsu C., Lai S., Shih C. Ten-Year Experience with Surgical Repair of Mycotic Aortic Aneurysms. J Chin Med Assoc 2005; 68(6):265-271.
[2] Kota A. A, Sen I., Dheepak Selvaraj A., Premkumar P., Ponraj S., Agarwal S. Mycotic aneurysm case serie. Indian Journal of vascular and endovascular surgery, Jan-Mars 2015, Issue 1, Vol 2, Page 38-40.
[3] Kyriakides C., Kan Y., Kerle M., Cheshire NJ., Mansfield AO., Wolfe JH. 11 Years experience with anatomical and extra-anatomical repair of mycotic aortic aneurysms. Eur J Vasc Endovasc Surg 2004; 27:585-9.
[4] Muller BT., Wegener OR., Grabitz K., Pillny M., Thomas I., Sandmann W. Mycotic aneurysms of the thoracic and abdominal aorta and iliac arteries: experience with anatomic and extraantomic repair in 33 cases. J Vasc Surg 2001;33:106-13.
[5] Burdon J. R, Ravat F., Desthieux J. M, Descotes J. Les anévrismes mycotiques des membres inférieurs . A propos de 21 cas. Chirurgie, 1988, 114 :482-9.
[6] Oderich GS, Panneton JM, Bower TC, Cherry KJ, Rowland CM, Noel AA et al. Infected aortic aneurysms: aggressive presentation, complicated early outcome, but durable results. J Vasc Surg. 2001;34:900-8.
[7] Jorna FH, Verhoeven EL, Bos WT, Prins TR, Dol JA, Reijnen MM. Treatment of a ruptured thoracoabdominal aneurysm with a stent-graft covering the celiac axis. J Endovasc Ther 2006;13:770-4.
[8] Stanley BM, Semmens JB, Lawrence-Brown MM, Denton M, Grosser D. Endoluminal repair of mycotic thoracic aneurysms. J Endovasc Ther 2003;10:511-5.
[9] Roeke T., Hovsibian S., Schlejen P., Dinant S., Koster T., Waasdorp E. A mycotic aneurysm of the abdominal aorta caused by Mycobacterium bovis after intravesical instillation with bacillus Calmette-Guérin. J Vasc Surg Cases and Innovative Techniques 2018; 4:122-5.
[10] Mikail N., Benali K., Ou P., Slama J., Hyafil F., Le Guludec D., Rouzet F. Detection of Mycotic Aneurysms of Lower Limbs By Whole-Body F-FDG-PET. JACC: Cardiovascular Imaging. Vol 8;n 7, 2015 July:859-62.
[11] Pessinaba S., Kane Ad., Ndiaye M. B., et al. Vascular complications of infective endocarditis. Médecine et Maladies infectieuses 42 (2012) 213-217, http//dx.doi.org/10.1016/j.medmal.2012.03.001.
[12] Peters PJ, Harrisson T, Lennox JLA dangerous dilemma: management of infectious intracranial aneurysms complicating endocarditis. Lancet Infect Dis 6: 742-748, 2006.
[13] Sonneville R, Mirabel M, Hajage D. et al. Neurologic complications and outcomes of infective endocarditis in critically ill patients: The endocardite en reanimation prospective multicenter study. Crit Care Med 39: 1474-1481, 2011.
[14] Leon LR, Psalms SB, Labropoulos N, Mills JL. Infected upper extremity aneurysms: a review. Eur J Vasc Endovasc Surg 35:320-331, 2008.
[15] Kang GC, Wong CH, Lee JY. Simultaneous infected pseudoaneurysm and suppurative tenosynovitis resulting from radial artery cannulation. Surg Infect (Larchmt) 9:489-492, 2008.
[16] Deser S. B., Demirag M. K. Infective endocarditis and incidental popliteal artery mycotic aneurysm. Cor and Vasa 59 (2017) e291-e293.
[17] Polytarchou K., et al. Ulnar pseudoaneurysm complicating infective endocarditis. The role of endovascular stenting. Hellenic Journal of Cardiology (2017), https://doi.org/10.1016/j.hjc.2017.11.007.
[18] Deipolyi AR., Bailin A., Khademhosseini A., Oklu R. Imaging Findings, Diagnosis and Clinical Outcomes in Patients With Mycotic Aneurysms: Single Center Experience. Clinical Imaging 40(2016) 512-516.
[19] Karkos C. D, Kalogirou T. E, Giagtzidis I. T, Papazoglou K. O. Ruptured Mycotic common femoral artery pseudoaneurysm. Tex Heart Inst J 2014;41(6):634-7.
[20] Mani K., Bjork M., Lunkvist J., Wanhaine A. Improved long term survival after abdominal aortic aneurysm repair. Circulation 2009; 120:201-11.
[21] Moneta G. L, Taylor L. M. Jr, Yeager R. A, and al. Surgical treatment of infected aortic aneurysm. Am J Surg 1998; 175:396-9.
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    Momar Sokhna Diop, Ndeye Fatou Sow, Pape Ousmane Ba, Magaye Gaye, Papa Amath Diagne, et al. (2019). Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases). Cardiology and Cardiovascular Research, 3(1), 1-5. https://doi.org/10.11648/j.ccr.20190301.11

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    ACS Style

    Momar Sokhna Diop; Ndeye Fatou Sow; Pape Ousmane Ba; Magaye Gaye; Papa Amath Diagne, et al. Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases). Cardiol. Cardiovasc. Res. 2019, 3(1), 1-5. doi: 10.11648/j.ccr.20190301.11

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    AMA Style

    Momar Sokhna Diop, Ndeye Fatou Sow, Pape Ousmane Ba, Magaye Gaye, Papa Amath Diagne, et al. Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases). Cardiol Cardiovasc Res. 2019;3(1):1-5. doi: 10.11648/j.ccr.20190301.11

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  • @article{10.11648/j.ccr.20190301.11,
      author = {Momar Sokhna Diop and Ndeye Fatou Sow and Pape Ousmane Ba and Magaye Gaye and Papa Amath Diagne and Pape Adama Dieng and Souleymane Diatta and Pape Salmane Ba and Moussa Seck Diop and Mareme Soda Mbaye and Amadou Gabriel Ciss and Assane Ndiaye and Mouhamadou Ndiaye},
      title = {Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)},
      journal = {Cardiology and Cardiovascular Research},
      volume = {3},
      number = {1},
      pages = {1-5},
      doi = {10.11648/j.ccr.20190301.11},
      url = {https://doi.org/10.11648/j.ccr.20190301.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ccr.20190301.11},
      abstract = {Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to evaluate the results of the surgery. Materials and Methods: This was a descriptive retrospective study over a 12-years period from December 2005 to February 2018. Results: The total number of our series was 12 cases. The average age at the time of surgery was 37 years old [17-83 years]. There was no predominance of sex. There was a notion of smoking in 3 cases / 12. There was no concept of addiction. Four out of 12 cases had a known concept of heart disease with mitral insufficiency, aortic insufficiency, and complete atrioventricular block. A patient presented in this antecedents a notion of syphilis treated and declared cured. The clinical symptomatology was made of fever in 4 cases out of 12, pain in 11 cases out of 12 with 3 cases of intermittent claudication. The clinical examination had shown a swelling with vascular characters in 11 cases out of 12. Two out of 12 patients had signs of acute limb ischemia. The arterial echodoppler was performed in 11cases out of 12 which had made the diagnosis. The angioscan was performed in 8 cases and showed 4 cases of sacciform aneurysms. All patients benefited from open surgery. The exploration showed 9 cases of false aneurysms with signs of local infection in 5 cases. Flattening with excision of the infected tissues was performed in all cases. The restoration of vascular continuity was immediate in all cases by end-to-end direct anastomosis in 8 cases, 2 cases of extra-anatomical bypass using a dacron tube and two cases of anatomical bypass using the saphenous vein in situ. Early complications were dominated by 2 cases of acute limb ischemia, 2 cases of superficial surgical site infection, 1 case of deep surgical site infection, 1 case of false aneurysm of a common femoral artery and 1 case of hematoma. Follow-up was performed in all patients with an average delay of 14 months [1-60]. There were 1 case of operative mortality and 2 cases of late mortality.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Mycotic Aneurysms: Clinical Aspects and Results of Surgery (About 12 Cases)
    AU  - Momar Sokhna Diop
    AU  - Ndeye Fatou Sow
    AU  - Pape Ousmane Ba
    AU  - Magaye Gaye
    AU  - Papa Amath Diagne
    AU  - Pape Adama Dieng
    AU  - Souleymane Diatta
    AU  - Pape Salmane Ba
    AU  - Moussa Seck Diop
    AU  - Mareme Soda Mbaye
    AU  - Amadou Gabriel Ciss
    AU  - Assane Ndiaye
    AU  - Mouhamadou Ndiaye
    Y1  - 2019/01/24
    PY  - 2019
    N1  - https://doi.org/10.11648/j.ccr.20190301.11
    DO  - 10.11648/j.ccr.20190301.11
    T2  - Cardiology and Cardiovascular Research
    JF  - Cardiology and Cardiovascular Research
    JO  - Cardiology and Cardiovascular Research
    SP  - 1
    EP  - 5
    PB  - Science Publishing Group
    SN  - 2578-8914
    UR  - https://doi.org/10.11648/j.ccr.20190301.11
    AB  - Introduction: Mycotic aneurysms have an incidence of 1 to 2%. Before the era of antibiotics, syphilis was most commonly observed. However, with the increase in arterial interventional procedures and intravenous drug use, Gram-positive organisms such as Staphylococcus and Streptococcus are observed. Objectives: To analyze the clinical aspects and to evaluate the results of the surgery. Materials and Methods: This was a descriptive retrospective study over a 12-years period from December 2005 to February 2018. Results: The total number of our series was 12 cases. The average age at the time of surgery was 37 years old [17-83 years]. There was no predominance of sex. There was a notion of smoking in 3 cases / 12. There was no concept of addiction. Four out of 12 cases had a known concept of heart disease with mitral insufficiency, aortic insufficiency, and complete atrioventricular block. A patient presented in this antecedents a notion of syphilis treated and declared cured. The clinical symptomatology was made of fever in 4 cases out of 12, pain in 11 cases out of 12 with 3 cases of intermittent claudication. The clinical examination had shown a swelling with vascular characters in 11 cases out of 12. Two out of 12 patients had signs of acute limb ischemia. The arterial echodoppler was performed in 11cases out of 12 which had made the diagnosis. The angioscan was performed in 8 cases and showed 4 cases of sacciform aneurysms. All patients benefited from open surgery. The exploration showed 9 cases of false aneurysms with signs of local infection in 5 cases. Flattening with excision of the infected tissues was performed in all cases. The restoration of vascular continuity was immediate in all cases by end-to-end direct anastomosis in 8 cases, 2 cases of extra-anatomical bypass using a dacron tube and two cases of anatomical bypass using the saphenous vein in situ. Early complications were dominated by 2 cases of acute limb ischemia, 2 cases of superficial surgical site infection, 1 case of deep surgical site infection, 1 case of false aneurysm of a common femoral artery and 1 case of hematoma. Follow-up was performed in all patients with an average delay of 14 months [1-60]. There were 1 case of operative mortality and 2 cases of late mortality.
    VL  - 3
    IS  - 1
    ER  - 

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Author Information
  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

  • Department of Cardiovascular and Thoracic Surgery, Cheikh Anta Diop University, Dakar, Senegal

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