Abstract |
Conventional extraanatomic reconstruction for aortic sepsis is associated with a significant risk of operative death, as well as frequent late complications. We evaluated in situ aortic grafting in the treatment of primary or graft-related aortic infection. Eleven selected patients underwent in situ aortic graft reconstruction in the setting of mycotic aneurysm (n = 5), secondarily infected aortic aneurysm (n = 1), primary aortoenteric fistula (n = 1), and secondary aortoenteric fistula (n = 4). All patients survived: follow-up from 10 to 130 months reveals no evidence for graft thrombosis, pseudoaneurysm, new or recurrent aortoenteric fistula, or subsequent aortic operations in any patient. A literature review produced 110 cases of aortic sepsis managed by in situ aortic reconstruction during the last decade. Thirty-two patients (29%) either died in the operative period or suffered a lethal late complication associated with their aortic reconstruction. This mortality rate declined to 21% if patients undergoing incomplete removal of a contaminated graft were excluded, and to 19% with the addition of our 11 patients. Both our experience and that described in the literature suggest that, in properly-selected patients, in situ aortic graft replacement may be a rational treatment option for localized or circumscribed aortic sepsis.
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Authors | J A Robinson, K Johansen |
Journal | Journal of vascular surgery
(J Vasc Surg)
Vol. 13
Issue 5
Pg. 677-82; discussion 682-4
(May 1991)
ISSN: 0741-5214 [Print] United States |
PMID | 2027207
(Publication Type: Journal Article)
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Topics |
- Adult
- Aged
- Aortic Diseases
(surgery)
- Bacterial Infections
(surgery)
- Blood Vessel Prosthesis
- Female
- Humans
- Male
- Methods
- Middle Aged
- Postoperative Complications
(surgery)
- Reoperation
- Retrospective Studies
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