Treatment of aortic and peripheral prosthetic graft infections with bovine pericardium

Journal article


Publication Details

Author(s): Almási-Sperling V, Heger D, Meyer A, Lang W, Rother U
Journal: Journal of Vascular Surgery
Publication year: 2019
ISSN: 0741-5214


Abstract

Objective: Graft infections are rare but serious complications of vascular operations. The aim of this study was to evaluate the results of in situ reconstruction with bovine pericardium in infected aortic and peripheral vessel fields. Methods: A retrospective cohort study was conducted with a focus on the treatment of infected grafts with bovine pericardium. We retrospectively reviewed 19 consecutive patients with prosthetic graft infections and in situ repair with bovine pericardium. All operations were done between March 2015 and January 2018. No other materials were used. Excision of the infected graft, radical débridement of the infected tissue, and in situ reconstruction with bovine pericardium were applied in all patients. Short-term outcomes including primary patency, freedom of reinfection, mortality, and complication rates were analyzed. Results: Bovine pericardium was used in 19 patients (84% male) with a median age of 70 years (range, 56-84 years) to reconstruct the descending aorta (n = 1), abdominal aorta (n = 5), iliac artery (n = 4), and femoral artery (n = 9). Graft infections were observed in all patients (one thoracic endovascular aneurysm repair, three infrarenal endovascular aneurysm repairs, two open aortic repairs, four iliac-femoral reconstructions, and nine femoral reconstructions including two closure device infections after coronary angiography). Ten patients (53%) had a complication perioperatively and postoperatively. The 30-day mortality was 10.5%; the total mortality rate after 1 year was 32%. There was no reinfection after bovine reconstruction observed in our cohort. Graft occlusions were detected in two cases during follow-up (median, 6 months; range, 1-47 months). Conclusions: Bovine pericardium reconstruction shows a good short-term outcome after aortic or peripheral graft infections. It is associated with good patency, low reinfection rate, and acceptably low early mortality rate. It can be a good therapeutic option in prosthetic graft infections when in situ repair with a prosthetic (even soaked) or autologous vein or homograft is not recommended or is not possible.


FAU Authors / FAU Editors

Almási-Sperling, Veronika
Medizinische Fakultät
Lang, Werner apl. Prof. Dr.
Gefäßchirurgische Abteilung
Meyer, Alexander PD Dr.
Gefäßchirurgische Abteilung
Rother, Ulrich Dr. med.
Professur für Plastische Chirurgie und Handchirurgie


How to cite

APA:
Almási-Sperling, V., Heger, D., Meyer, A., Lang, W., & Rother, U. (2019). Treatment of aortic and peripheral prosthetic graft infections with bovine pericardium. Journal of Vascular Surgery. https://dx.doi.org/10.1016/j.jvs.2019.04.485

MLA:
Almási-Sperling, Veronika, et al. "Treatment of aortic and peripheral prosthetic graft infections with bovine pericardium." Journal of Vascular Surgery (2019).

BibTeX: 

Last updated on 2019-05-08 at 08:38