Infected abdominal aortic aneurysm treated by in situ replacement with cryopreserved arterial homograft

Infected abdominal aortic aneurysms are uncommon but not rare (1-3% of all abdominal aortic aneurysms). This life-threatening disease can lead to rapid uncontrolled sepsis and/or aortic rupture. We report one case that underlines two notions. Firstly computed tomography is effective to detect early stages of the pathology providing complete depiction of the anatomical abnormalities. Secondly infected aortic aneurysm can be successfully treated by antibiotherapy and in situ replacement with cryopreserved arterial homograft.     

A successfully treated case of intraoperative latex anaphylaxis during abdominal aorta aneurysm resection

We experienced resuscitation from latex anaphylaxis induced by surgical gloves during elective abdominal aorta aneurysm resection in a low risk adult with latex allergy. The patient developed severe circulatory collapse 10 minutes after the start of surgery. Although administration of dopamine, norepinephrine, and a large amount of fluid could not normalize this circulatory collapse, but addition of famotidine and chlorpheniramine could restore blood pressure. After resuscitation, we decided to postpone the operation. The re-operation was planned in the latex free setting one month later. All products, containing latex, had been excluded from operating room one day before the re-operation, and the patient entered operating room earlier than other patients to avoid latex-polluted powder from surgical gloves of other staffs. Y-shaped graft replacement was performed, and the perioperative course was uneventful. Latex is the second leading cause of intraoperative anaphylaxis, and the high-risk cases could be easily detected through the questionnaires, focusing on latex and other tropical fruits allergy. Moreover, because it is easy to get latex-free products, we recommend that a set of latex free products should be prepared at least for a high-risk case of latex allergy.     

Ruptured abdominal aortic aneurysm treated by ligation of the aorta and an axillobifemoral bypass

Although a few elderly patients do survive operation for a ruptured aortic aneurysm mortality in patients over 70 years of age is very high. An alternative operation to conventional Dacron replacement of the aorta has been devised. This involves occlusion of the infrarenal aorta and iliac arteries with large plastic clips and insertion of a Dacron axillobifemoral graft. Eight patients with a mean age of 71 years were so treated. Half of them left hospital alive. We consider the results justify further use of this operation in selected patients.     

Technical features of aneurysm resection and abdominal aorta reconstruction from mini-approach

Experience of surgical treatment of infrarenal aortic aneurysm from mini-approach at 42 patients is analyzed. Techniques of mini-invasive surgery, tactical aspects are described. Peri- and postoperative data at study group were compared with ones at control group consisted of 42 patients who underwent reconstructive operation on abdominal aorta with traditional median laparotomy. The operation time, volume of intravenous infusion, time of pulmonary ventilation, stay at intensive care department and postoperative enteroparesis were significantly less at the patients of study group. Mini-invasive techniques don't increase complexity of operation, and can be performed by surgeons without special training.