The Value of Registries for Rare Diseases

B acterial infections of the aorta are rare. The label mycotic aneurysm is misleading because mycoses or fungal infections of the aorta are even more rare. The management of bacterial infections of the aorta has always been considered difficult, largely because they frequently herald aortic rupture, and the outcomes of traditional surgery have been poor. Historically, these patients were managed by surgical resection of the aneurysm, debridement of the infected tissue, and revascularization using in situ or extra-anatomic techniques with either prosthetic or, less commonly, autologous grafts. However, the results of such surgery have been disappointing, with many patients being considered unfit to withstand the rigors of such major intervention and, therefore, palliated. Others have died as a result of the attempted curative surgery or had late infectious complications.