Document Detail


In situ reconstruction with cryopreserved arterial allografts for management of mycotic aneurysms or aortic prosthetic graft infections: a multi-institutional experience.
MedLine Citation:
PMID:  16572862     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We designed this study to evaluate a multi-institutional experience regarding the efficacy of cryopreserved aortic allografts in the treatment of infected aortic prosthetic grafts or mycotic aneurysms. We reviewed clinical data of all patients from 4 institutions who underwent in situ aortic reconstruction with cryopreserved allografts for either infected aortic prosthetic graft or mycotic aneurysms from during a 6-year period. Relevant clinical variables and treatment outcomes were analyzed. A total of 42 patients (37 men; overall mean age 63 +/- 13 years, range 41-74 years) were identified during this study period. Treatment indications included 34 primary aortic graft infections (81%), 6 mycotic aneurysms (22%), and 2 aortoenteric erosions (5%). Transabdominal and thoracoabdominal approaches were used in 38 (90%) and 4 patients (10%), respectively. Staphylococcus aureus was the most commonly identified organism (n=27, 64%). Although there was no intraoperative death, the 30-day operative mortality was 17% (n=7). There were 21 (50%) nonfatal complications, including local wound infection (n=8), lower-extremity deep venous thrombosis (n=5), amputation (n=6), and renal failure requiring hemodialysis (n=2). The average length of hospital stay was 16.4 +/- 7 days. During a mean follow-up period of 12.5 months, reoperation for allograft revision was necessary in 1 patient due to graft thrombosis (6%). The overall treatment mortality rate was 21% (n=9). In situ aortic reconstruction with cryopreserved allografts is an acceptable treatment method in patients with infected aortic prosthetic graft or mycotic aneurysms. Our study showed that mid-term graft-related complications such as reinfection or aneurysmal degeneration were uncommon.
Authors:
Wei Zhou; Peter H Lin; Ruth L Bush; Thomas T Terramani; John H Matsuura; Mitchell Cox; Eric Peden; Marlon Guerrero; Eric J Silberfein; Alan Dardik; David Rosenthal; Alan B Lumsden
Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital     Volume:  33     ISSN:  0730-2347     ISO Abbreviation:  Tex Heart Inst J     Publication Date:  2006  
Date Detail:
Created Date:  2006-03-31     Completed Date:  2006-08-30     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  8214622     Medline TA:  Tex Heart Inst J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  14-8     Citation Subset:  IM    
Affiliation:
Div. of Vascular Surgery and Endovascular Therapy, Michael E. DeBakey Dept. of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aneurysm, Infected / surgery*
Aorta / transplantation*
Aortic Aneurysm / microbiology*,  surgery*
Blood Vessel Prosthesis / adverse effects*
Cryopreservation*
Female
Humans
Male
Middle Aged
Prosthesis-Related Infections / surgery*
Retrospective Studies
Comments/Corrections

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


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