Xenopericardial roll graft replacement for infectious pseudoaneurysms and graft infections of the aortaReportar como inadecuado




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Journal of Cardiothoracic Surgery

, 10:133

First Online: 27 October 2015Received: 23 February 2015Accepted: 26 October 2015

Abstract

BackgroundWhich graft material is the optimal graft material for the treatment of infected aortic aneurysms and aortic graft infections is still a matter of controversy. Orthotopic aortic reconstruction with intraoperatively prepared xenopericardial roll grafts without omentopexy was performed as the -initial- operation to treat aortic infection or as a -rescue- operation to treat graft infection. Mid-term outcomes were evaluated.

MethodsBetween 2009 and 2013, orthotopic xenopericardial roll graft replacement was performed to treat eight patients male-female: 6-2; mean age: 69.5 55–80 yr. Graft material: equine-bovine pericardium: 2-6; type of operation: initial 4-rescue 4; omentopexy 0. Additional operation: esophagectomy 2. Mean follow-up period: 2.6 ± 1.6 1.1–5.1 years.

ResultsReplacement: ascending 3, arch 1 reconstruction of neck vessels with small xenopericardial roll grafts, descending 3, and thoracoabdominal 1. Pathogens: MRSA 2, MSSA 1, Candida 1, E. coli 1, oral bacillus 1, and culture negative 2. Postoperative local recurrence of infection: 0. Graft-related complications: stenosis 0, calcification 0, non-infectious pseudoaneurysm of anastomosis 2 surgical repair: 1-TEVAR 1. In-hospital mortality: 2 MOF: initial 1-rescue 1; Survival rate exclusive of in-hospital deaths ~3 y: 100 %, but one patient died of lung cancer 3.6 yr.

ConclusionsBecause xenopericardial roll grafts are not composed of synthetic material, the replacement procedure is simpler and less invasive than the standard procedure. Based on the favorable results obtained, this procedure may have the possibility to serve as an option for the treatment of aortic infections and aortic graft infections not only as a -rescue- treatment but as an -initial- treatment as well.

KeywordsAortic operation Pseudoaneurysm Biomaterials Esophageal injury Esophageal perforation Infection Graft infection Xenograft Equine pericardium Bovine pericardium Electronic supplementary materialThe online version of this article doi:10.1186-s13019-015-0343-5 contains supplementary material, which is available to authorized users.

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Autor: Hiroshi Kubota - Hidehito Endo - Mio Noma - Hikaru Ishii - Hiroshi Tsuchiya - Akihiro Yoshimoto - Yu Takahashi - Yusuke In

Fuente: https://link.springer.com/







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