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Eur J Cardiothorac Surg 1999;16:613-618
© 1999 Elsevier Science NL

Does focal destruction of the thoracic aorta wall by Staphylococcus aureus lead to the development of infected aneurysms? An experimental study

^a Research Unit-Hemodynamic Service, University Hospital ‘San Cartlos’, Madrid, Spain
^b Pathology Service, University Hospital ‘Príncipe de Asturias’, Alcalá de Henares, Madrid, Spain
^c Pathology Service, University Hospital ‘La Paz’, Madrid, Spain

Corresponding author. C/ Santa Virgilia 11, Esc. Izq. 3° B. 28033 Madrid, Spain. Tel.: +34-91-330-3289; fax: +34-91-330-3289
e-mail: mahcschemo{at}insalud.es

Objective: The infrequency of infected aneurysms suggests that either infection of segments of the aortic wall is uncommon, or that infections do not always lead top infected aneurysm formation. The purpose of the study was to determine whether focal Staphylococcus aureus infection of aortic wall segments leads consistently to the development of infected aneurysms and to evaluate the segments in which infection did not lead to the infected aneurysm formation. Methods: Twenty pigs were inoculated with 0.1 ml of a Staphylococcus aureus inoculum in three segments of the thoracic aorta wall (study group). In another 10 pigs, 0.1 ml of saline solution was injected in three segments of the thoracic aorta wall (control group). Study group: histological abnormalities and bacterial culture of the inoculation sites were evaluated at 10 days (n=5 pigs), 30 days (n=5 pigs), and 90 days (n=10 pigs). Control group: histological abnormalities were evaluated at 10 days (n=5 pigs) and 90 days (n=5 pigs). Results: Study group: infected aneurysms developed in only two animals killed at 30 days. At 90 days, destruction of the elastic tissue, scar tissue and neointima formation were found in all the aortic segments studied. Control group: no significant changes were found in any of the segments evaluated. Conclusion: In our experimental model, acute local infection by S. aureus caused the development of infected aortic aneurysm in only 10% of the animals. In the remaining 90%, healing of the site of infection followed resolution of the infection.

Key Words: Staphylococcus aureus • Infected aneurysms • Infection • Healing