Surgical strategies are discussed for treating aorta-related infections, which are rare but have a high mortality. The standard treatment is open surgical repair with resection of infected tissue, debridement, and in situ graft replacement or extra-anatomical bypass. For 71 patients with aorta infections, 70 underwent open surgical repair and resection or endovascular repair, while 1 received medical therapy. Complete resection of infected tissue, in situ graft replacement, and omentopexy followed by rifampicin-soaked grafts is the standard strategy, though endovascular repair may be used for localized infections or as a bridge to open surgery.

1. Journal Reading
Surgical strategy for
aorta-related infection
China Medical University Int.吳易儒

3. Background
● Aorta related infection
○ rare
○ high mortality
● Standard treatment:
○ open surgical repair with resection
○ debridement
○ in situ graft replacement
○ extra anatomical bypass
● Endovascular repair
○ useless

4. Meterials and Methods
● 71(3.3%) patients had aorta-related
infections
○ 70- open surgical repair+ resection/ endovascular
repair
○ 1- medical therapy
● Aorta infection diagnosed by:
○ clinical course
○ CT
○ blood culture(+)
○ histopathological examination

7. Surgical treatment
● Debridement of infected tissue
● Copious saline irrigation
● In situ graft replacement
● Endovascular repair
○ localized infected site
○ immunocompromised host
○ bridge to open surgical repair

8. Standard surgical strategy
● Complete resection of infected tissue
● in situ graft replacement of the aorta
● rifampicin-soaked, gelatin-impregnated
Dacron graft
● followed by omentopexy
● 70 patients:
○ 45: insitu replacdment
○ 18: endovascular aortic repair
○ 7: extra-anatomical bypass

9. Surgical strategy
● Before 2008: resect infected tissue and
abscess
● Since 2008: also resect surrounding
aneurysmal wall
● 29: Omental flap install
● 3: Pedicled latissmus dorsi muscle flap

10. Result

11. Figure 1

12. Figure 2A

13. Figure 2B

14. Figure 2C

15. Figure 3

16. Figure 4

17. Thanks for your attention