Document Detail


Cryopreserved arterial homografts for in situ reconstruction of mycotic aneurysms and prosthetic graft infection.
MedLine Citation:
PMID:  8800699     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The management of mycotic aneurysms and prosthetic graft infection of major thoracic and abdominal vessels and infected extra-anatomic bypass remains a problem in vascular surgery. Cryopreserved arterial homografts, being resistant to infection, offer hope for in situ vascular reconstruction in the presence of an infection. We analyzed clinical, microbiological, preoperative and postoperative magnetic resonance imaging (MRI), computed tomography (CT), echocardiography and/or angiography data in 12 patients with mycotic aneurysm or prosthetic graft infection, in whom cryopreserved arterial homografts were used to replace infected segments of major thoracic and abdominal vessels. The hospital mortality was 8.3%. The average postoperative hospital stay was 18 +/- 14.5 days (6 to 45); antibiotic treatment was continued for 31 +/- 12 days (4 to 42). During the mean follow-up time of 18.6 +/- 12.8 months (2 to 48) two patients died, but only one (9%) was homograft-related. Recurrence of infection, suture line problems or homograft stenosis or aneurysm were not observed. Therefore, in situ replacement with cryopreserved arterial homografts is an effective treatment for mycotic aneurysms and graft infection of thoracic aorta, abdominal aortic/iliac vessels and infected extra-anatomic bypass. This operative technique has a low early and late mortality, obviates the need for complex extra-anatomic reconstruction, allows safe in situ repair, reduces postoperative antibiotic requirements, shortens the hospital stay and renders early or medium-term reoperations unnecessary.
Authors:
P R Vogt; L K von Segesser; Y Goffin; M Pasic; M I Turina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  9     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  1995  
Date Detail:
Created Date:  1996-09-30     Completed Date:  1996-09-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  502-6     Citation Subset:  IM    
Affiliation:
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Infected / etiology,  surgery*
Aorta, Abdominal / transplantation
Aorta, Thoracic / transplantation
Aortic Aneurysm / surgery*
Arteries / transplantation*
Blood Vessel Prosthesis / adverse effects*
Cryopreservation*
Female
Femoral Artery / transplantation
Follow-Up Studies
Humans
Male
Middle Aged
Prosthesis-Related Infections / etiology,  surgery*
Transplantation, Homologous

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


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