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Tran HV, Ho DK, Le VH, Van Duong H. Ruptured tuberculous aneurysms of the abdominal aorta: Two case series. Int J Surg Case Rep 2022; 92:106860. [PMID: 35231736 PMCID: PMC8886133 DOI: 10.1016/j.ijscr.2022.106860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/17/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Ruptured aneurysms secondary to the tuberculous infection of the aorta are a rare and life-threatening disease. We report a single-center experience of two patients with ruptured infrarenal tuberculous aneurysms. Case presentation We report 2 patients with ruptures of the tuberculous aneurysm. All patients had acute abdominal pain and were diagnosed by echography then CT scan preoperatively. The first patient (male, 50 years old) had a ruptured saccular aneurysm. The second patient (male, 43 years old) had a retroperitoneal contained rupture. All were treated by open prosthetic repair, by vascular surgeons. The two patients were well after operations. The diagnosis was confirmed by pathology examination. Antituberculous treatment was introduced after the operation. Conclusions Ruptured tuberculous aneurysms are rare but life-threatening. The diagnosis requires a high degree of suspicion. The treatment includes early diagnosis and emergent surgical intervention, extensive excision of infected field, aortic reconstruction, and prolonged antituberculous drug therapy. The tuberculous aortic aneurysm is a fatal condition if not early diagnosed and properly treated. The diagnosis requires a high degree of suspicion. Surgery is necessary for stenotic or aneurysmal lesions. The treatment should be a combination of surgery and antituberculous medication.
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2
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TEVAR for thoracic mycotic aneurysm: Case report. Int J Surg Case Rep 2021; 81:105753. [PMID: 33770636 PMCID: PMC7994787 DOI: 10.1016/j.ijscr.2021.105753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/07/2021] [Accepted: 03/07/2021] [Indexed: 12/02/2022] Open
Abstract
Rare cause of mycotic aortic pseudoaneurysm. Sacciform aneurysm with high rate of mortality secondary to aneurysm rupture regadless its size. Open Surgery was the reference treatement, althoough accopagned with great risks. TEVAR with anti tuberculosis drugs have revolutionized the management and the outcomes of thoracic mycotic aneurysms.
Introduction Mycobacterium tuberculosis is a cause of mycotic aortic pseudoaneurysms, wich are a rare case with high mortality rates. Three types of dissemination hematogenous by contiguity and direct to the aortic wall are possibles. Presentation of case We report a rare case of tuberculous thoracic aortic pseudo aneurysm, successfully treated endovascularly associated to antituberculosis drugs. Discussion Classically TB pseudoaneurisms have been treated with open surgical therapy.however, they are associated to high morbidity and mortaity with increased lenghts of hospital stay. Due to advancements of endovascular technology, it be cames a good and successful alternative as a treatment, with a background of medical treatment. Conclusion Thoracic endovascular aneurysm repair (TEVAR) associated to anti-tuberculosis medication have revolutionized the management and improved the prognosis of this pathology.
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3
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Delaval L, Goulenok T, Achouh P, Saadoun D, Gaudric J, Pellenc Q, Kahn JE, Pasi N, van Gysel D, Bruneval P, Papo T, Sacre K. New insights on tuberculous aortitis. J Vasc Surg 2017; 66:209-215. [DOI: 10.1016/j.jvs.2016.11.045] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 11/14/2016] [Indexed: 10/20/2022]
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4
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Abstract
Significant vascular complications are rare following systemic infections with Mycobacterium tuberculosis (TB). This report describes a 33-year-old man who presented with a short history of abdominal discomfort and febrile episodes with no prior history of infection with TB. Ultrasound, CT scan, and aortography confirmed the presence of a pseudoaneurysm originating from the posterior aspect of the supraceliac aorta at the level of the diaphragm. Via a full thoracoabdominal approach, periaortic inflammatory tissue and the aortic wall itself were debrided, and repair of the pseudoaneurysm was achieved with a synthetic patch. Mycobacterium tuberculosis was isolated from the aortic wall, and anti-TB medications were instituted. Postoperatively the patient did well and was discharged after 14 days. As illustrated by this case, tuberculous mycotic aneurysms of the aorta are optimally treated with a combination of medical and surgical therapy, and early diagnosis is essential to ensure survival.
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Affiliation(s)
- Thomas L Forbes
- Division of Vascular Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
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5
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Tijani Y, Ghannam A, Elfatemi B, Elkharroubi A, Hormat-Allah M, Elidrissi R, Elkhloufi S, Sefiani Y, Lekehal B, Elmesnaoui A, Ammar F, Bensaid Y. [The aneurysms of the aorta of tuberculous]. Ann Cardiol Angeiol (Paris) 2016; 65:107-110. [PMID: 26656506 DOI: 10.1016/j.ancard.2015.09.047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/03/2015] [Indexed: 06/05/2023]
Abstract
Tuberculosis is a public health problem in Morocco, which is difficult to eradicate despite the recognized efficiency of health policies. Aortic aneurysm is rare and lethal complication of spontaneous evolution. Pathophysiological characteristics and the difficulty of early diagnosis worsen the prognosis.
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Affiliation(s)
- Y Tijani
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc.
| | - A Ghannam
- Service d'anesthésie réanimation, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - B Elfatemi
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - A Elkharroubi
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - M Hormat-Allah
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - R Elidrissi
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - S Elkhloufi
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - Y Sefiani
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - B Lekehal
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - A Elmesnaoui
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - F Ammar
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
| | - Y Bensaid
- Service de chirurgie vasculaire, université Mohammed V, CHU Ibn Sina, Souissi Rabat, Maroc
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6
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Seo DJ, Kim JB. Tuberculous aortitis complicated with pseudoaneurysm formation in the descending thoracic aorta: a case report. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2012; 45:408-11. [PMID: 23275925 PMCID: PMC3530727 DOI: 10.5090/kjtcs.2012.45.6.408] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 08/23/2012] [Accepted: 08/24/2012] [Indexed: 12/04/2022]
Abstract
A 51-year-old male with sustained fever was diagnosed with military tuberculosis and tuberculous aortitis complicated with pseudoaneurysm formation at the proximal descending aorta. A follow-up computed tomography evaluation showed an increased size of the pseudoaneurysm in this area, suggestive of a contained rupture. Consequently, the patient underwent emergency excision and replacement of the aorta using a left heart bypass. The patient was discharged without postoperative complications on post-operative day 12. During the one-year follow-up period, the patient was free of any complications or recurrence of tuberculosis. We report a case of pseudoaneurysm of the descending aorta that was successfully surgically repaired.
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Affiliation(s)
- Dong Ju Seo
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
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7
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Attenberger UI, Michaely HJ, Schoenberg SO, Rieger J. Imaging of non-atherosclerotic aneurysmal disease. Eur J Radiol 2011; 80:41-9. [DOI: 10.1016/j.ejrad.2010.12.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Accepted: 12/29/2010] [Indexed: 10/18/2022]
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8
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Avaro JP, Amabile P, Paule P, Peloni JM, Piquet P. An unusual combination of a tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta. Ann Vasc Surg 2011; 25:700.e9-700.e12. [PMID: 21724110 DOI: 10.1016/j.avsg.2010.12.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 09/10/2010] [Accepted: 12/13/2010] [Indexed: 11/30/2022]
Abstract
Tuberculous aneurysms of the aorta are rare and give rise to various issues related to their diagnosis and treatment. In this article, we report on an exceptional case concerning a patient who presented with a false tuberculous aneurysm of the thoracic aorta and a degenerative aneurysm of the infrarenal abdominal aorta concomitantly. A discussion on how we approached the diagnosis and devised a therapeutic strategy that allowed us to treat this dual aortic disease effectively has also been provided. The discussion includes details of the order of treatment and the choice between an endovascular and a surgical approach.
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Affiliation(s)
- Jean-Philippe Avaro
- Department of Thoracic Surgery, Military Hospital Laveran, Marseille, France.
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9
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Park SC, Moon IS, Koh YB. Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta. Ann Vasc Surg 2010; 24:417.e11-3. [DOI: 10.1016/j.avsg.2009.05.019] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2009] [Accepted: 05/28/2009] [Indexed: 11/24/2022]
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10
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Endovascular Stent Graft Placement in the Treatment of Ruptured Tuberculous Pseudoaneurysm of the Descending Thoracic Aorta: Case Report and Review of the Literature. Cardiovasc Intervent Radiol 2008; 32:572-6. [DOI: 10.1007/s00270-008-9456-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2008] [Revised: 08/28/2008] [Accepted: 09/03/2008] [Indexed: 10/21/2022]
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11
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Clerc O, Jaton K, Prod'hom G, Von Segesser L, Greloz V, Greub G. Mycobacterium tuberculosis aortic graft infection with recurrent hemoptysis: a case report. J Med Case Rep 2008; 2:233. [PMID: 18634553 PMCID: PMC2491651 DOI: 10.1186/1752-1947-2-233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2007] [Accepted: 07/18/2008] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Mycobacterium tuberculosis may cause a large variety of clinical presentations due to its ability to disseminate by contiguity or hematogenously. Tuberculosis may remain undiagnosed for years due to the chronic course of the disease, with potentially life-threatening long-term complications. CASE PRESENTATION In this case report, we describe a tuberculous aortic graft infection in a 72-year-old man documented by polymerase chain reaction and cultures. The patient presented with three episodes of hemoptysis following a remote history of miliary tuberculosis. The infection was treated by graft replacement and prolonged antimycobacterial therapy. CONCLUSION Tuberculous infection of a vascular graft is an uncommon complication, but should be considered in patients with an intravascular device and a history of previous tuberculosis, especially when hematogenous spread may have occurred a few months after surgery, or when an active mycobacterial infection is present in close proximity to the graft.
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Affiliation(s)
- Olivier Clerc
- Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Katia Jaton
- Institute of Microbiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Guy Prod'hom
- Institute of Microbiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Ludwig Von Segesser
- Cardiovascular Surgery Department, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Vincent Greloz
- Pathology Department, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
| | - Gilbert Greub
- Infectious Diseases Service, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
- Institute of Microbiology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Switzerland
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12
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Labrousse L, Montaudon M, Le Guyader A, Choukroun E, Laurent F, Deville C. Endovascular treatment of a tuberculous infected aneurysm of the descending thoracic aorta: A word of caution. J Vasc Surg 2007; 46:786-8. [PMID: 17903655 DOI: 10.1016/j.jvs.2007.05.038] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2006] [Accepted: 05/15/2006] [Indexed: 10/22/2022]
Abstract
An infected aneurysm of the thoracic aorta due to mycobacterium tuberculosis is an unusual entity for which the classical treatment is antituberculosis chemotherapy and open-chest surgery. Recent improvements in endovascular treatments have led to their proposed use for infected aneurysms in patients for whom open surgery poses too high a risk. We report on a 68-year-old man with a tuberculous aortic aneurysm who had been treated with an endoprosthesis and antituberculosis chemotherapy. His clinical and radiological follow-up was uneventful and led to the discontinuation of pharmacological treatment after 16 months. However, a recurrence of the infection led to a fatal aortic rupture 4 months after discontinuation of therapy.
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MESH Headings
- Aged
- Aneurysm, Infected/diagnostic imaging
- Aneurysm, Infected/drug therapy
- Aneurysm, Infected/microbiology
- Aneurysm, Infected/therapy
- Aorta, Thoracic/diagnostic imaging
- Aortic Aneurysm, Thoracic
- Aortic Rupture/etiology
- Blood Vessel Prosthesis Implantation
- Fatal Outcome
- Humans
- Male
- Radiography
- Recurrence
- Tuberculosis, Cardiovascular/diagnosis
- Tuberculosis, Cardiovascular/diagnostic imaging
- Tuberculosis, Cardiovascular/drug therapy
- Tuberculosis, Cardiovascular/therapy
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Affiliation(s)
- Louis Labrousse
- Department of Cardio-Vascular Surgery, Bordeaux Heart University Hospital, Bordeaux-Pessac, France.
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13
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Affiliation(s)
- Zakeya A. Bukhary
- Department of Medicine, College of Medicine, Taibah University, Saudi Arabia
| | - Abdulrahman A. Alrajhi
- Section of Infectious Diseases, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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14
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Suresh K, Kurian VM, Madhu Sankar N, Patel A, Joseph P, Cherian KM. Repair of tuberculous aneurysm of distal aortic arch. Asian Cardiovasc Thorac Ann 2004; 11:346-8. [PMID: 14681099 DOI: 10.1177/021849230301100417] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 65 year old female patient presented with one episode of massive haemoptysis requiring transfusion and subsequently cough with streaky haemoptysis. Computerized tomographic scan and angiogram revealed aneurysm of the distal aortic arch. She underwent elective repair of the pseudoaneurysm through median sternotomy and the bronchial communication was closed through left thoracotomy. Tubercle bacilli were identified in the contents and excised wall of aortic tissue.
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Affiliation(s)
- Keshavamurthy Suresh
- Institute of Cardiovascular Diseases, 4A Dr. J J Nagar, Mogappair, Chennai 600-050, India
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15
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Tuberculous Vasculitis and Mycotic Aneurysms. Tuberculosis (Edinb) 2004. [DOI: 10.1007/978-3-642-18937-1_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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16
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17
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Abstract
Tuberculous aortitis generally develops at the distal aortic arch and the descending aorta that are close to specific groups of mediastinal lymph nodes, but exceptionally it develops in the ascending aorta. We report a case of rupture of the ascending aorta after tuberculous aortitis in a 53-year-old man without a history of tuberculosis or evidence of a primary foci who underwent cardiopulmonary resuscitation due to severe hemoptysis with subsequent cardiac arrest. The tuberculous aortitis associated with rupture of the ascending aorta was treated with surgical resection and in situ graft placement.
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Affiliation(s)
- Jong Bum Choi
- Department of Thoracic and Cardiovascular Surgery, Wonkwang University Hospital, Iksan, Jeonbuk, South Korea.
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18
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Hatem CM, Kantis GA, Christoforou D, Gold JP, Plestis KA. Tuberculous aneurysm of the descending thoracic aorta. J Thorac Cardiovasc Surg 2002; 123:373-4. [PMID: 11828309 DOI: 10.1067/mtc.2002.120721] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Carlo M Hatem
- Department of Medicine, Montefiore Medical Center, The University Hospital of the Albert Einstein College of Medicine, Bronx, NY 10461, USA
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19
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Abstract
BACKGROUND Tubercular pseudoaneurysm of aorta is a rare but important complication of tuberculosis. With worldwide resurgence of tuberculosis due to increasing incidence of drug-resistant tuberculosis and its association with acquired immunodeficiency syndrome, the tubercular pseudoaneurysm has become a real clinical entity. METHODS In the past 3 years, 5 young patients (22 to 40 years) presented with tubercular pseudoaneurysm. Site of involvement included ascending aorta, distal aortic arch, proximal descending thoracic aorta, distal descending thoracic aorta, and infrarenal abdominal aorta. Two patients had macroscopic focus of tuberculosis in the nearby vicinity, and all 5 patients had evidence of active/treated pulmonary pericardial tuberculosis. All patients either had received antitubercular therapy previously or were receiving it at the time of presentation. Rapid deterioration in the clinical status was the most marked clinical feature. All patients underwent operation. Graft interposition was performed in 2, patch repair in 2, and direct closure of the rent was performed in 1 patient. All 5 patients received antitubercular therapy in the postoperative period. RESULTS All patients survived the operation and were discharged from the hospital. One patient developed recurrence at the original site after 8 months and died at reoperation. The remaining patients are symptom free at 18 to 36 months postoperatively. CONCLUSIONS A combination of chemotherapy and operation yields gratifying results for the treatment of tubercular pseudoaneurysm.
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MESH Headings
- Adult
- Antitubercular Agents/administration & dosage
- Aorta, Abdominal/pathology
- Aorta, Abdominal/surgery
- Aorta, Thoracic/pathology
- Aorta, Thoracic/surgery
- Aortic Aneurysm, Abdominal/diagnosis
- Aortic Aneurysm, Abdominal/pathology
- Aortic Aneurysm, Abdominal/surgery
- Aortic Aneurysm, Thoracic/diagnosis
- Aortic Aneurysm, Thoracic/pathology
- Aortic Aneurysm, Thoracic/surgery
- Aortic Diseases/diagnosis
- Aortic Diseases/pathology
- Aortic Diseases/surgery
- Blood Vessel Prosthesis Implantation
- Combined Modality Therapy
- Humans
- Image Processing, Computer-Assisted
- Imaging, Three-Dimensional
- Magnetic Resonance Imaging
- Male
- Tomography, X-Ray Computed
- Tuberculosis, Cardiovascular/diagnosis
- Tuberculosis, Cardiovascular/pathology
- Tuberculosis, Cardiovascular/surgery
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Affiliation(s)
- S K Choudhary
- Cardiothoracic Centre, All India Institute of Medical Sciences, Ansari Nagar, New Delhi
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20
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Lagattolla NR, Baghai M, Biswas S, Redington AE, Downie AC, Miburn HJ, Taylor PR. Tuberculous false aneurysm of the femoral artery managed by endoluminal stent graft insertion. Eur J Vasc Endovasc Surg 2000; 19:440-2. [PMID: 10801384 DOI: 10.1053/ejvs.1999.1064] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- N R Lagattolla
- Department of Vascular Surgery, Guy's Hospital, St. Thomas Street, London, SE1 9RT, United Kingdom
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21
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Abstract
Pseudoaneurysm of the femoral artery is an extremely rare complication of tuberculosis. We present a case of tuberculous femoral pseudoaneurysm that was successfully treated with resection, direct anastomosis, and postoperative antituberculous chemotherapy.
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Affiliation(s)
- C L Kao
- Department of Thoracic Surgery, Chang Gung Memorial Hospital, Kaohsiung, Taiwan, Republic of China
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22
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Allins AD, Wagner WH, Cossman DV, Gold RN, Hiatt JR. Tuberculous infection of the descending thoracic and abdominal aorta: case report and literature review. Ann Vasc Surg 1999; 13:439-44. [PMID: 10398742 DOI: 10.1007/s100169900280] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
We report here a case of infrarenal aortic disruption and aortoduodenal fistula secondary to tuberculous aortitis in a 77-year-old man. From a review of experience with operative management of tuberculous infection of the descending thoracic and abdominal aorta reported in the English-language literature, including the current report, we found that operative repair was attempted in 26 patients with tuberculous aortitis of the abdominal (n = 16), thoracic (n = 8), and thoracoabdominal (n = 2) aorta. Six patients had emergent operations for massive hemoptysis (n = 2), aortoduodenal fistula (n = 2), or abdominal rupture (n = 2), with an associated 30-day mortality of 50%. Elective or semi-elective repair was undertaken in 20 patients, of whom 19 (95%) survived for at least 30 days. On the basis of limited experience with this rare entity, in situ graft replacement is an appropriate treatment of tuberculous aneurysms and pseudoaneurysms of the descending thoracic and abdominal aorta.
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Affiliation(s)
- A D Allins
- Division of Vascular Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA
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23
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Bojar RM, Turner MT, Valdez S, Haskal R, McGowan K, Khabbaz KR. Homograft repair of a tuberculous pseudoaneurysm of the ascending aorta. Chest 1998; 114:1774-6. [PMID: 9872219 DOI: 10.1378/chest.114.6.1774] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
A 34-year-old HIV-positive black man with pulmonary tuberculosis developed progressive widening of the mediastinum. Evaluation by CT and two-dimensional echocardiography demonstrated a large saccular aneurysm of the ascending aorta. This was repaired with a 26-mm aortic homograft using deep hypothermic circulatory arrest. The microbiology of the aneurysm contents showed this to be a tuberculous pseudoaneurysm.
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Affiliation(s)
- R M Bojar
- Division of Cardiothoracic Surgery, New England Medical Center and the Tufts University School of Medicine, Boston, MA 02111, USA.
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