Document Detail


In situ repair of aortobronchial, aortoesophageal, and aortoenteric fistulae with cryopreserved aortic homografts.
MedLine Citation:
PMID:  9240315     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The surgical treatment of fistulae that originate from aortic aneurysms or prosthetic aortic grafts carries a high mortality rate. We investigated whether in situ repair with cryopreserved aortic homografts would improve the outcome.
METHODS: Between April 1994 and June 1996, 11 patients (mean age, 62 +/- 10 years) with aortobronchial, aortoesophageal, or aortointestinal fistulae originating from mycotic aneurysms (five of 12) or prosthetic aortic grafts (six of 12) underwent in situ replacement of the thoracic (seven of 10) or abdominal (four of 10) aorta with homografts. Emergency surgery was performed in eight of 11 patients (73%).
RESULTS: The hospital mortality rate was 9%; there was one sudden cardiac death on the seventh postoperative day. The mean hospital stay was 42 +/- 26 days (range, 21 to 90 days). After surgery, antibiotics were given for 38 +/- 6 days (range, 28 to 42 days). Neither reinfection, suture line rupture, nor anastomotic aneurysms were observed by magnetic resonance angiography, computed tomography, angiography, or transesophageal echocardiography after 14.3 +/- 8.2 months (range, 6 to 31 months). In one patient, percutaneous vascular stent placement was necessary after 18 months for an anastomotic stenosis of a thoracic homograft.
CONCLUSIONS: In situ repair with cryopreserved aortic homografts seems to be a promising step in the treatment of aortobronchial, aortoesophageal, and aortointestinal fistulae. This technique has a low operative mortality rate and may prevent reinfection.
Authors:
P R Vogt; T Pfammatter; R Schlumpf; M Genoni; A Künzli; D Candinas; G Zünd; M Turina
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  26     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-08-21     Completed Date:  1997-08-21     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  11-7     Citation Subset:  IM    
Affiliation:
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aorta / transplantation*
Aortic Aneurysm / complications
Aortic Diseases / etiology,  surgery*
Bronchial Fistula / surgery*
Cryopreservation
Esophageal Fistula / surgery*
Female
Fistula / etiology,  surgery*
Humans
Intestinal Fistula / surgery*
Male
Middle Aged
Vascular Surgical Procedures / mortality

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


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