| Retroperitoneal in-line aortic bypass for treatment of infected infrarenal aortic grafts. | |
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MedLine Citation:
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PMID: 1448729 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Since 1970, we have treated 43 patients with infected aortic grafts. Early in the series, four patients were treated with resection of the fistula or erosion and systemic and topical antibiotics without removal of the graft. All four patients died. Thirty-two patients were treated by conventional therapy; there were 13 deaths (40 percent). More recently, seven patients were managed by the left retroperitoneal placement of a new in-line polytetrafluoroethylene (PTFE) aortic graft through clean tissue planes, followed by the immediate transperitoneal removal of the infected graft without cross-contamination. Patients were maintained postoperatively on antibiotics for a minimum of two weeks. All seven patients survived without septic complications, with a mean follow-up time of 36 months (six months to four years). The surgical technique consists of initial suprarenal control of the aorta, followed by infrarenal division and oversewing of the distal aorta. A PTFE bifurcation graft is placed connecting the proximal aorta and the appropriate femoral vessels, the right limb tunneled through the space of Retzius. After closure of the incisions, through the space of Retzius. After closure of the incisions, the patient is placed in the supine position and the infected graft is removed transperitoneally. We believe that retroperitoneal in-line aortic bypass for treatment of an infected aortic graft offers a favorable alternative to conventional therapy by avoiding the use of an extra-anatomic bypass and associated risk of stump blowout. |
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Authors:
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R P Leather; R C Darling; B B Chang; D M Shah |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Surgery, gynecology & obstetrics Volume: 175 ISSN: 0039-6087 ISO Abbreviation: Surg Gynecol Obstet Publication Date: 1992 Dec |
Date Detail:
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Created Date: 1992-12-24 Completed Date: 1992-12-24 Revised Date: 2009-11-11 |
Medline Journal Info:
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Nlm Unique ID: 0101370 Medline TA: Surg Gynecol Obstet Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 491-4 Citation Subset: AIM; IM |
Affiliation:
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Vascular Surgery Section, Albany Medical College, New York 12208. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Anti-Bacterial Agents
/
administration & dosage,
therapeutic use Aortic Diseases / surgery* Blood Vessel Prosthesis / adverse effects*, standards Combined Modality Therapy Follow-Up Studies Hospital Mortality Hospitals, University Humans New York / epidemiology Polytetrafluoroethylene / therapeutic use* Prosthesis-Related Infections / etiology, mortality, surgery* Reoperation / methods*, standards Survival Rate |
| Chemical | |
Reg. No./Substance:
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0/Anti-Bacterial Agents; 9002-84-0/Polytetrafluoroethylene |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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