Experience with cryopreserved arterial allografts in the treatment of prosthetic graft infections

被引:41
作者
Nevelsteen, A
Feryn, T
Lacroix, H
Suy, R
Goffin, Y
机构
[1] UZ Gasthuisberg, Dept Vasc Surg, B-300 Louvain, Belgium
[2] Int Assoc, European Homograft Bank, Brussels, Belgium
来源
CARDIOVASCULAR SURGERY | 1998年 / 6卷 / 04期
关键词
arterial surgery; atherosclerosis; prosthetic infection; allograft; aorto-enteric fistula;
D O I
10.1016/S0967-2109(98)00014-3
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The authors present a retrospective study on 30 patients with prosthetic graft infection. Included are 25 patients with aortic graft infection, three with infection of a femorodistal bypass and two with infected axillofemoral grafts. There were 23 isolated primary prosthetic graft infections and seven aorto-enteric fistulas, Treatment consisted of graft excision and replacement with cryopreserved arterial homografts, harvested from brain-death multi-organ donors. The in situ technique was used in 27 cases. Eight patients died postoperatively and two deaths were from allograft related complications. The operative mortality rate was 11% for isolated aortic graft sepsis and the early limb salvage rate was 100%, Persistent or recurrent infection was noted in two cases. The mean follow-up of the series was 24.5 months and occlusive complications occurred in five patients (23%), which resulted in two major amputations. Serial CT scans showed abnormalities in six of the 22 survivors, all of them related to the aortic segment of the allograft, It is concluded that in situ reconstruction with cryopreserved arterial allografts represents an acceptable alternative, especially in the treatment of isolated aortic graft sepsis, Continued follow-up towards late deterioration and/or occlusive complications remains mandatory. (C) 1998 The International Society for Cardiovascular Surgery. Published by Elsevier Science Ltd. All rights reserved.
引用
收藏
页码:378 / 383
页数:6
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