Mycotic Aortic Aneurysms

Various studies have evaluated the possibilities of surgical repair of mycotic aortic aneurysms (MAAs). Open surgical repair has usually been accepted as the gold standard treatment of MAAs. The main concern is that it carries a significant mortality risk, varying from 20 to 40% in different studies, and a 5-year survival rate of 30–50%. The largest study of open surgical treatment of mycotic aortic aneurysms (MAA) was published in 2018, and consisted of 187 patients of whom open repairs were performed in 107 patients (57%). Most of the endovascular series conclude that endovascular treatment of MAA is feasible and an acceptable alternative treatment to open repair. Although endovascular repair might be a durable option for some patients, late infection-associated complications frequently occur and are often lethal. An overall analysis of this rare pathology, its different diagnostic modalities, treatment options, and prognosis are presented and discussed in this chapter.