Surgical Treatment of the Infected Aortic Graft

Mapping Intimacies ◽

10.2310/vasc.3057 ◽

2017 ◽

Author(s):

Jayer Chung

Keyword(s):

Preoperative Evaluation ◽

Graft Infection ◽

Prosthetic Graft ◽

Vascular Reconstruction ◽

Graft Material ◽

Aortic Graft ◽

Operative Planning ◽

Femoral Vessels ◽

Aortic Graft Infection ◽

Autogenous Reconstruction

The primary goal of treatment in dealing with an infected aortic graft is to save life and limb. This goal is best accomplished by eradicating all infected graft material and maintaining adequate circulation with appropriate vascular reconstruction. This review describes the choice of procedures, including an extra-anatomic bypass, an aortic allograft, an antibiotic-treated prosthetic graft, and an in situ autogenous reconstruction. Once a procedure has been decided on, preoperative evaluation and operative planning must take place. The review describes operative technique from the thigh incision and exposure of the femoral vessels to closure. Postoperative care is described. Outcomes and complications are discussed. Special consideration is given to aortoenteric fistulas. This review contains 8 figures, 2 tables, and 83 references. Key words: antibiotic-impregnated Dacron, aortic graft infection, aortoenteric erosion, aortoenteric fistula, axillobifemoral bypass, cryopreserved allograft, neoaortoiliac surgery

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Biosynthetic vascular graft: a valuable alternative to traditional replacement materials for treatment of prosthetic aortic graft infection?

Scandinavian Journal of Surgery ◽

10.1177/1457496918816908 ◽

2018 ◽

Vol 108 (4) ◽

pp. 291-296 ◽

Cited By ~ 3

Author(s):

T. Betz ◽

D. Neuwerth ◽

M. Steinbauer ◽

C. Uhl ◽

K. Pfister ◽

...

Keyword(s):

Perioperative Complications ◽

Vascular Grafts ◽

Graft Infection ◽

Prosthetic Graft ◽

Graft Material ◽

Aortic Graft ◽

Valuable Alternative ◽

Aortic Graft Infection ◽

Omniflow Ii

Background and Aims: To report the experience of a tertiary vascular surgery center using Omniflow II® biosynthetic vascular grafts for treatment of prosthetic aortic graft infection. Materials and methods: Retrospective analysis of all patients with prosthetic graft infections who underwent in situ aortic reconstruction using Omniflow II® grafts or other conduits between March 2015 and May 2017. Early and late mortality, perioperative complications, and reinfection rate were analyzed. Results: Sixteen patients (14 males, median age 68.5, range 57–89) with prosthetic aortic graft infection were treated at our center. Eight patients received an Omniflow II® biosynthetic graft, two patients silver-triclosan coated grafts, three patients bovine pericardial tube grafts, and three patients composite bovine pericardial tube grafts with Omniflow II® graft extensions. Perioperative complications occurred in seven patients (43.8%). Early mortality rate was 18.7% (n = 3). In addition, four patients died during follow-up after a median of 11 months (range 0–34 months). We did not observe any reinfections. Bypass grafts were patent in all patients. No major limb amputations were performed during follow-up. Conclusion: Treatment of prosthetic aortic graft infection with Omniflow II® vascular grafts is feasible. Graft material seems to have an excellent resistance to infection and might be a valuable alternative to traditional replacement materials. Especially long-term durability has to be continuously monitored and documented.

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Unclear Reason of Recurrent Graft Infections after Aortobifemoral Reconstruction

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2021.6056 ◽

2021 ◽

Vol 9 (C) ◽

pp. 59-62

Author(s):

Srdjan Babic ◽

Vuk Jovanovic ◽

Milan Marinkovic ◽

Slobodan Tanaskovic ◽

Predrag Gajin ◽

...

Keyword(s):

Surgical Treatment ◽

Gastrointestinal Tract ◽

Clinical Presentation ◽

Case Reports ◽

Graft Infection ◽

Vascular Reconstruction ◽

Aortic Graft ◽

Imaging Procedures ◽

First Choice ◽

Aortic Graft Infection

BACKGROUND: Aortic graft infection is one of the most serious complications of vascular reconstruction with the incidence of 1%. The clinical presentation can vary, which delays the diagnosis. CASE REPORTS: Infections in our patients affected iliac, inguinal region, and retroperitoneum, which are not relatively common sites of graft infection. We present clinical presentation, imaging procedures, and surgical treatment of three patients with unknown cause of late graft infection after 6, 7, and 9 years. CONCLUSION: In our presentations, the etiological factors of the infection are not known, but they suggest that events in the gastrointestinal tract may be related to them. Aggressive surgery should be taken into consideration as a first choice in the similar cases.

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Aortic Graft Infection as a Cause of Multiple Brain Infarcts

Case Reports in Cardiology ◽

10.1155/2012/575169 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Vassiliki Tsirka ◽

Jelena Maletic ◽

Panagiotis Ioannidis ◽

Dimitrios Karacostas

Keyword(s):

Previous History ◽

Graft Infection ◽

Prosthetic Graft ◽

Acute Onset ◽

Aortic Graft ◽

Aortic Valves ◽

Brain Infarcts ◽

History Of ◽

Aortic Graft Infection ◽

Echocardiographic Evidence

Brain embolism of cardiac origin is common in clinical practice. However, embolic brain infarcts due to aortic graft infection are very rare. We present a case of a 53-year-old woman with multiple brain infarcts, following an infection of ascending aortic graft. She was presented with fever and acute onset neurological deficit, and she had a previous history of replacement of ascending aorta with a prosthetic graft, because of aortic aneurysm 2 years before her admission. The patient had positive blood cultures and echocardiographic evidence of vegetation in the graft aortic joint, nearby the aortic valves. Despite the severe clinical condition and the poor prognosis, because of the coexistence of cardioembolism and aortic graft infection, our patient had a good outcome with conservative treatment and she will be considered for surgical graft replacement after her full recovery.

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