Surgical repair of descending thoracic and thoracoabdominal aortic aneurysms in patients with human immunodeficiency virus infection: a 10-patient series

Nirvana Sadaghianloo; Caroline Goulfier; Marie-Hélène Fléron; Julien Gaudric; Fabien Koskas; Laurent Chiche

doi:10.1016/j.avsg.2015.03.045

Surgical repair of descending thoracic and thoracoabdominal aortic aneurysms in patients with human immunodeficiency virus infection: a 10-patient series

Ann Vasc Surg. 2015 Aug;29(6):1196-202. doi: 10.1016/j.avsg.2015.03.045. Epub 2015 May 22.

Authors

Nirvana Sadaghianloo¹, Caroline Goulfier², Marie-Hélène Fléron³, Julien Gaudric², Fabien Koskas², Laurent Chiche⁴

Affiliations

¹ Department of Vascular Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France.
² Department of Vascular Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France; University Pierre et Marie Curie (Paris VI), Paris, France.
³ Department of Vascular Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France; Department of Anesthesiology and Critical Care, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France.
⁴ Department of Vascular Surgery, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière University Hospital, Paris, France; University Pierre et Marie Curie (Paris VI), Paris, France. Electronic address: laurent.chiche@psl.aphp.fr.

PMID: 26004953
DOI: 10.1016/j.avsg.2015.03.045

Abstract

Background: Major surgery in patients with human immunodeficiency virus (HIV) infection increases the risk of complications such as cardiovascular morbidity and opportunistic infections.

Methods: This study reports our experience with open surgical repair of 10 descending thoracic and thoracoabdominal aortic aneurysms in patients with HIV.

Results: Seven were men, and their median age was 49 years. All patients were controlled with highly active antiretroviral therapy (mean CD4+: 613/mm(3)). Three patients died (1 preoperatively, 1 after rupture, and 1 after elective surgery). No patient had spinal cord ischemia or infectious complications, either early or after a median follow-up of 29 months. Bacteriologic and histologic analyses did not determine any specific etiology for the aneurysms.

Conclusions: Surgical repair of descending thoracic and thoracoabdominal aortic aneurysms in patients with HIV infection is feasible and may not lead to remote infectious complications.

MeSH terms

Adult
Antiretroviral Therapy, Highly Active
Aortic Aneurysm, Thoracic / diagnosis
Aortic Aneurysm, Thoracic / mortality
Aortic Aneurysm, Thoracic / surgery*
Blood Vessel Prosthesis Implantation / adverse effects*
Blood Vessel Prosthesis Implantation / mortality
Female
HIV Infections / complications*
HIV Infections / diagnosis
HIV Infections / drug therapy
HIV Infections / mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome