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Infectious aortitis

Guidelines

Key sources

The following summarized guidelines for the management of infectious aortitis are prepared by our editorial team based on guidelines from the American Heart Association (AHA/ACC 2022). ...
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Medical management

Setting of care
As per ACC/AHA 2022 guidelines:
Determine the most suitable intervention in patients with acute aortic disease requiring urgent repair by a multidisciplinary team.
B
Consider referring asymptomatic patients with extensive aortic disease, patients likely to benefit from complex open and endovascular aortic repairs, and patients with multiple comorbidities eligible for an intervention to a high-volume center (performing at least 30-40 aortic procedures annually) with experienced surgeons in a multidisciplinary aortic team to optimize treatment outcomes.
C
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  • Shared decision-making

  • Antibiotic therapy

Nonpharmacologic interventions

Physical activity: as per ACC/AHA 2022 guidelines, provide education and guidance about avoiding intense isometric exercises (such as heavy weightlifting or activities requiring the Valsalva maneuver), burst exertion and activities, and collision sports in patients with significant aortic disease.
B

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  • Psychosocial care

Surgical interventions

Indications for repair: as per ACC/AHA 2022 guidelines, perform open surgical repair in patients with infectious aortitis and associated aneurysms or dissection of the thoracic or abdominal aorta.
B
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Specific circumstances

Patients with aortic graft infection: as per ACC/AHA 2022 guidelines, consider obtaining cross-sectional imaging to evaluate for an underlying aortic graft infection in patients with a prosthetic aortic graft having signs and symptoms or culture evidence of unexplained infection or unexplained gastrointestinal bleeding.
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