| Management of Thoracic Aortic Graft Infections With the Omental Flap. | |
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MedLine Citation:
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PMID: 22868324 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Infection of thoracic aortic grafts occurs infrequently; however, once present, it is associated with high patient morbidity and mortality. We report our successful experience in the treatment of 11 patients who developed infection of their thoracic aortic graft. METHODS: This is an institutional review board-approved retrospective review of 11 patients who had documented thoracic aortic graft infections with associated mediastinitis or empyema. After diagnosis, plastic surgery consultation was obtained, and the patients underwent formal operative debridement with cardiovascular service. Intraoperative cultures were obtained, and the patients were placed on specific antibiotic regimens. After the wound bed was adequately prepared, the omentum was harvested and was based on the right gastroepiploic vessels. The flap was circumferentially wrapped around the aortic graft and simultaneously used to fill the mediastinal dead space. In a certain subset of patients, a cryopreserved homograft replaced the synthetic graft before omental flap reconstruction. RESULTS: The infections were eventually controlled in all surviving patients. Ten of 11 patients were discharged either to a rehab or to a nursing facility. There was 1 perioperative death secondary to multisystem organ failure. Mean follow-up period was 36 months and revealed a greater than 90% survival rate. Serial imaging reported no suture-line complications. CONCLUSIONS: We report our series on the treatment of patients with infection of thoracic aortic grafts. Debridement and tissue coverage with an omental flap provided these patients with successful recovery and survival. |
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Authors:
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Samir Shah; Sammy Sinno; Darl Vandevender; Jeffery Schwartz |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-8-3 |
Journal Detail:
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Title: Annals of plastic surgery Volume: - ISSN: 1536-3708 ISO Abbreviation: Ann Plast Surg Publication Date: 2012 Aug |
Date Detail:
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Created Date: 2012-8-7 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7805336 Medline TA: Ann Plast Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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From the *Division of Plastic and Reconstructive Surgery, Department of Cardiovascular Surgery, Loyola University Medical Center, Proviso, IL; and Institute of Reconstructive Plastic Surgery, New York University Medical Center, New York, NY. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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