PMID- 3767509
OWN - NLM
STAT- MEDLINE
DCOM- 19861107
LR  - 20190628
IS  - 0003-4975 (Print)
IS  - 0003-4975 (Linking)
VI  - 42
IP  - 4
DP  - 1986 Oct
TI  - Patch closure of aortic annulus mycotic aneurysms.
PG  - 372-9
AB  - Twenty-three patients with bacterial endocarditis and mycotic aneurysms of the 
      aortic annulus were treated between 1978 and 1985. There were 18 men and 5 women 
      ranging from 24 to 72 years old. All patients had congestive heart failure and 
      positive blood cultures as a complication of the endocarditis and were in New 
      York Heart Association (NYHA) Functional Class III or IV. The aneurysm 
      complicated late prosthetic valve endocarditis in 7 patients and native valve 
      endocarditis in 16. The most common infecting organisms were streptococci (12 
      patients) and staphylococci (7 patients). The noncoronary sinus was the most 
      frequent site for aneurysm formation. Following debridement of the abscess 
      cavity, the orifice of the aneurysm was closed with a patch of Dacron in 20 
      patients and autologous pericardium in 3. A prosthetic valve (18 bioprosthetic 
      and 5 mechanical) was secured to the noninfected portion of the native annulus 
      and to the patch at the level of annulus. There were 3 deaths, 1 perioperative 
      and 2 late, each without evidence of residual infection or aortic insufficiency. 
      There are 20 late survivors (87%). After a mean follow-up of 1 year, all patients 
      are in NYHA Functional Class I. Patch closure of mycotic aneurysms involving the 
      aortic annulus permits aggressive debridement of the abscess cavity and affords 
      closure of the orifice without tension. The prosthetic valve can be seated at the 
      level of the native annulus, thus avoiding complicated reconstructive procedures 
      of the aortic root and coronary arteries. This technique is an effective 
      alternative in selected cases of mycotic aneurysms involving the aortic annulus.
FAU - Fiore, A C
AU  - Fiore AC
FAU - Ivey, T D
AU  - Ivey TD
FAU - McKeown, P P
AU  - McKeown PP
FAU - Misbach, G A
AU  - Misbach GA
FAU - Allen, M D
AU  - Allen MD
FAU - Dillard, D H
AU  - Dillard DH
LA  - eng
PT  - Journal Article
PL  - Netherlands
TA  - Ann Thorac Surg
JT  - The Annals of thoracic surgery
JID - 15030100R
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aneurysm, Infected/*surgery
MH  - Aortic Valve/*surgery
MH  - Bioprosthesis
MH  - Endocarditis, Bacterial/*surgery
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Aneurysm/*surgery
MH  - *Heart Valve Prosthesis
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
EDAT- 1986/10/01 00:00
MHDA- 1986/10/01 00:01
CRDT- 1986/10/01 00:00
PHST- 1986/10/01 00:00 [pubmed]
PHST- 1986/10/01 00:01 [medline]
PHST- 1986/10/01 00:00 [entrez]
AID - S0003-4975(10)60539-5 [pii]
AID - 10.1016/s0003-4975(10)60539-5 [doi]
PST - ppublish
SO  - Ann Thorac Surg. 1986 Oct;42(4):372-9. doi: 10.1016/s0003-4975(10)60539-5.