Infected Aortic Grafts and Mycotic Aneurysms
Key takeaways
An infected aortic graft is a rare but serious problem. It happens when bacteria or fungi infect a synthetic tube, called a graft, that was placed during earlier aortic surgery.
A mycotic aneurysm is a bulge or weak area in an artery wall caused by an active infection, not by normal aging or wear and tear.
Main symptoms include: Ongoing fever, unexplained chills, tiredness, and severe pain in the back, chest, or abdomen.
Primary Treatments: A combination of long-term, high-dose intravenous (IV) antibiotics and complex surgery to remove the infection and rebuild the blood vessel.
Both conditions are medical emergencies and need care from a highly specialized team, such as the experts at the UF Health Aortic Disease Center.
What are infected grafts and mycotic aneurysms?
Infected aortic grafts and mycotic aneurysms are complex, dangerous infections that involve the body’s aorta.
- Infected Aortic Grafts: During surgery to fix an aortic problem, doctors usually use a man-made tube called a graft to repair the vessel. If bacteria get into the bloodstream, they can attach to this foreign material. Since the immune system has trouble fighting bacteria on synthetic material, the graft can become infected.
- Mycotic Aneurysms: Despite the word "mycotic" (which usually means fungal), most of these aneurysms are actually caused by bacteria. An infection weakens a specific spot in the artery wall, causing it to balloon outward. These aneurysms grow rapidly and have a very high risk of rupturing.
Both conditions are medical emergencies because they can damage the artery wall, which may cause severe internal bleeding or dangerous blood infections like sepsis.
Who do they affect?
These infections are rare, but certain factors significantly increase a patient’s risk:
Past Aortic Surgery: Anyone with a synthetic aortic graft or stent-graft may develop a graft infection, even years after their original surgery.
Weakened Immune Systems: People with diabetes, chronic kidney disease, cancer undergoing chemotherapy or HIV are more vulnerable.
Intravenous (IV) Drug Use: Injecting drugs can introduce dangerous bacteria directly into the bloodstream.
Existing Infections: A bacterial infection in another part of the body, like the heart valves (endocarditis) or bones (osteomyelitis), can travel through the blood and reach the aorta.
Symptoms to look out for
Unlike typical aortic aneurysms, which rarely cause symptoms until they are large, infected grafts and mycotic aneurysms almost always make a person feel sick. Symptoms include:
A persistent, unexplained fever.
Drenching night sweats and chills.
Continuous, severe pain in the abdomen, back, or chest.
Unintended, rapid weight loss and general fatigue.
A sore, throbbing lump in the belly.
If the infection gets into the blood, it can cause sepsis. Get emergency help right away if you notice confusion, a fast heartbeat, quick breathing, or a sudden drop in blood pressure.
How are these conditions treated?
Treating an infected graft or a mycotic aneurysm requires a highly coordinated, two-step approach: eliminating the infection and safely rerouting blood flow.
1. Intensive antibiotic therapy
Patients start high-dose IV antibiotics right away to stop the bacteria from growing. An infectious disease specialist usually manages this treatment, which must continue for weeks or months after surgery. Sometimes, patients need to take oral antibiotics for life.
2. Complex surgical reconstruction
Antibiotics alone are usually not enough because bacteria can hide in infected tissue and on synthetic materials. Surgery is almost always needed and includes:
Removing the Infection: The surgeon must completely cut away the infected section of the aorta or completely remove the old, infected synthetic graft.
Rebuilding the Aorta: Because placing a new synthetic plastic graft into an infected area carries a high risk of reinfection, our cardiothoracic and vascular surgeons often use biological tissue. This may include using a vein taken from the patient's own leg or a specially prepared donor vein (homograft) to rebuild the blood highway.
Frequently asked questions
Why is it called a "mycotic" aneurysm if it is usually caused by bacteria?
The term mycotic was first used in the 1800s by a well-known doctor named William Osler. He chose the word because the infected, bulging artery looked like a mushroom on the vessel. Even though the name stayed, doctors now know that bacteria such as Staphylococcus or Salmonella cause most of these cases, not fungi.
How does a surgical graft get infected years after the operation?
Bacteria can enter your blood through things that happen every day. This can include routine dental procedures, severe skin infections or urinary tract infections. Once in the bloodstream, the bacteria can travel to the site of your previous surgery and attach to the artificial fabric of the graft, slowly growing into an infection..
Can these infections be cured without surgery?
In almost all cases, surgery is necessary. Synthetic grafts do not have a natural blood supply. This means your body’s immune cells and IV antibiotics cannot easily reach the bacteria hiding on the plastic's surface. Surgery is the only definitive way to physically remove the source of the infection.
What is the recovery time after surgery for an infected graft?
Recovery from these procedures is longer and more intense than standard aortic surgeries. This is because the body is also fighting off a major infection. Patients normally spend one to two weeks in the hospital, followed by several weeks of home health care to complete their IV antibiotic therapy.
Why choose the UF Health Aortic Disease Center?
Treating infected grafts and mycotic aneurysms takes advanced surgical skill and a strong support team. The UF Health Aortic Disease Center performs some of the highest numbers of aortic surgeries in the country, especially for these complex cases. Our vascular surgeons work closely with infectious disease experts, imaging specialists and critical care teams to perform high-risk aortic reconstructions using advanced biological tissue options.
If you or a loved one are experiencing signs of an aortic infection, please contact the UF Health Aortic Disease Center immediately at 352-273-5494.
This entry was written by Gabrielle Massari, Marketing Content Writer, and reviewed for accuracy by Eric Jeng, MD. Generative AI was leveraged as part of the content creation process.