Xenopericardial roll graft replacement for infectious pseudoaneurysms and graft infections of the aorta View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2015-12

AUTHORS

Hiroshi Kubota, Hidehito Endo, Mio Noma, Hikaru Ishii, Hiroshi Tsuchiya, Akihiro Yoshimoto, Yu Takahashi, Yusuke Inaba, Yoshifumi Nishino, Masao Nunokawa, Yutaka Hosoi, Tooru Ikezoe, Masaru Nemoto, Yoshihisa Makino, Yoko Nemoto, Mitsuru Matsukura, Masanori Sugiyama, Nobutsugu Abe, Hirohisa Takeuchi, Gen Nagao, Eri Kondo, Osamu Yanagida, Hideaki Yoshino, Kenichi Sudo

ABSTRACT

BACKGROUND: Which 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. METHODS: Between 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. RESULTS: Replacement: 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). CONCLUSIONS: Because 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. More... »

PAGES

133

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s13019-015-0343-5

DOI

http://dx.doi.org/10.1186/s13019-015-0343-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1021634125

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/26506850


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