Document Detail


Cryopreserved arterial allografts in the treatment of major vascular infection: a comparison with conventional surgical techniques.
MedLine Citation:
PMID:  9832688     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Recent findings with cryopreserved heart valve allografts in the treatment of infectious endocarditis suggest that the use of cryopreserved arterial allografts may improve the outcome in patients with vascular infections. METHODS: Seventy-two patients with mycotic aneurysms (n = 29) or infected vascular prostheses (n = 43) of the thoracic (n = 26) or abdominal aorta (n = 46) were treated with in situ repair and extra-anatomic reconstruction using prosthetic material (n = 38) or implantation of a cryopreserved arterial allograft (n = 34). Disease-related survival and survival free of reoperation were assessed. Morbidity, cumulative lengths of intensive care, hospitalization, antibiotic treatment, and costs were calculated per year of follow-up. RESULTS: The use of cryopreserved arterial allografts was superior to conventional surgery in terms of disease-related survival (P =.008), disease-related survival free of reoperation (P =.0001), duration of intensive care per year of follow-up (median 1 vs 11 days; range 1 to 42 vs 2 to 120 days; P =.001), hospitalization (14 vs 30 days; range 7 to 150 vs 15 to 240 days; P =.002), duration of postoperative antibiotic therapy (21 vs 40 days; range 21 to 90 vs 60 to 365 days; P =.002), incidence of complications (24% vs 63%; P =.005), and elimination of infection (91% vs 53%; P =.001). In addition, costs were 40% lower in the group treated by allografts (P =.005). CONCLUSIONS: The use of cryopreserved arterial allografts is a more effective treatment for mycotic aneurysms and infected vascular prostheses than conventional surgical techniques.
Authors:
P R Vogt; H P Brunner-La Rocca; T Carrel; L K von Segesser; C Ruef; J Debatin; B Seifert; W Kiowski; M I Turina
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  116     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-01-06     Completed Date:  1999-01-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  965-72     Citation Subset:  AIM; IM    
Affiliation:
Clinic for Cardiovascular Surgery, the Divisions of Cardiology and Infectious Diseases, the Clinic for Radiology, and the Department of Biostatistics, ISPM, University Hospital Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Aneurysm, Infected / etiology,  mortality,  surgery*
Aortic Aneurysm, Abdominal / etiology,  surgery
Aortic Aneurysm, Thoracic / etiology,  surgery
Arteries / cytology,  transplantation*
Blood Vessel Prosthesis / adverse effects*
Cost-Benefit Analysis
Cryopreservation*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Prosthesis-Related Infections / etiology,  mortality,  surgery*
Retrospective Studies
Transplantation, Homologous / economics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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