Self Made Xeno-pericardial Aortic Tubes to Treat Native and Aortic Graft Infections.

Weiss, Salome; Tobler, Eva-Luca; von Tengg-Kobligk, Hendrik; Makaloski, Vladimir; Becker, Daniel; Carrel, Thierry; Schmidli, Jürg; Wyss, Thomas (2017). Self Made Xeno-pericardial Aortic Tubes to Treat Native and Aortic Graft Infections. European journal of vascular and endovascular surgery EJVES, 54(5), pp. 646-652. Elsevier 10.1016/j.ejvs.2017.07.017

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OBJECTIVES The most appropriate material for reconstruction of the aorta for native or graft infection remains a matter for debate. This study examines the mid-term outcome of patients and graft durability after in situ aortic reconstruction with self made bovine pericardial tube grafts. METHODS This was a retrospective analysis of all patients who underwent in situ aortic reconstruction using self made bovine pericardial tube grafts between January 2008 and December 2015 at a tertiary referral centre. Peri-operative and mid-term outcomes including mortality and re-infection were analysed at the end of January 2017. Available follow-up imaging was reviewed to assess graft durability. RESULTS Bovine pericardial aortic tube grafts were used in 35 patients (86% male) with a median age of 69 years (range 38-84) to reconstruct the ascending aorta or the aortic arch (7), the descending (7), the thoraco-abdominal (7), or the abdominal (14) aorta. Twelve patients (34%) were treated for infection of the native aorta and 23 (66%) for prosthetic graft infection. Twenty-two patients (63%) underwent emergency surgery. Thirty day mortality was 31% (n = 11). Additionally, six patients died during follow-up after a median of 33 months (range 3-70). For the remaining patients, mean follow-up was 48 months (± 26) with a mean Follow-Up Index of 0.98 ± 0.08. There were no readmissions or re-operations for re-infection or graft related complications. Follow-up imaging showed no signs of graft degeneration after a median of 15 months (range 3-68). CONCLUSIONS Surgical treatment of native and aortic graft or endograft infection remains high risk. Self made bovine pericardial tube grafts for in situ reconstruction are a promising option offering many advantages. Despite high early mortality rates, early radiological and mid-term clinical results are good. Definitive eradication of the infection seems feasible after in situ insertion of xeno-pericardial material for aortic repair.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiovascular Surgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Weiss, Salome; von Tengg-Kobligk, Hendrik; Makaloski, Vladimir; Becker, Daniel; Carrel, Thierry; Schmidli, Jürg and Wyss, Thomas

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1078-5884

Publisher:

Elsevier

Language:

English

Submitter:

Daniela Huber

Date Deposited:

19 Sep 2017 10:51

Last Modified:

08 Nov 2017 01:31

Publisher DOI:

10.1016/j.ejvs.2017.07.017

PubMed ID:

28874328

Uncontrolled Keywords:

Aneurysm Aortic reconstruction Bioprosthesis Infected Pericardium/transplantation Prosthesis related infections

BORIS DOI:

10.7892/boris.105415

URI:

https://boris.unibe.ch/id/eprint/105415

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