HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Soyer, R. Articles by Arrignon, J. Search for Related Content PubMed PubMed Citation Articles by Soyer, R. Articles by Arrignon, J.

The Annals of Thoracic Surgery, Vol 58, 425-428, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Surgical treatment of infected composite graft after replacement of ascending aorta

R Soyer, JP Bessou, F Bouchart, M Redonnet, D Mouton-Schleifer and J Arrignon
Department of Thoracic and Cardiovascular Surgery, Hospital Charles Nicolle, Rouen, France.

Infection of a composite graft is a serious complication. However, reports of such cases are rare even in large series. We report our experience with 4 patients in whom infection of a composite graft developed with pseudoaneurysm formation. Two of the patients had Marfan's syndrome and were treated by Bentall procedure and 2 were treated by Cabrol technique for non-Marfan cystic medial necrosis. Staphylococcus epidermidis was detected in 2 patients and Enterococcus in 1. Reoperation was carried out between 1 and 32 months after the first intervention. One patient died of cerebral embolism and 3 remained free of infection 11 to 82 months later. These cases and guidelines for managing abdominal and peripheral vascular prosthetic infection indicate the need for prompt reintervention when infection is suspected from chronic sepsis, septicemia, positive blood cultures, fistula, anastomotic leak, hemolysis, embolism, graft deformity, or false aneurysm. When the organism is isolated, appropriate antibiotic therapy should be administered. All prosthetic material should be removed and all adjacent infected or necrotic tissue excised. Local antiseptic irrigation may be helpful. Dead space around the prosthesis should be filled with well-vascularized transposed pedicled flaps. Antibiotic therapy should be intravenously administered for at least 6 weeks.

This article has been cited by other articles:

				S. A. LeMaire and J. S. Coselli Options for managing infected ascending aortic grafts. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 839 - 843. [Full Text] [PDF]

				E. Akowuah, P. Narayan, G. Angelini, and A. J. Bryan Management of prosthetic graft infection after surgery of the thoracic aorta: Removal of the prosthetic graft is not necessary. J. Thorac. Cardiovasc. Surg., October 1, 2007; 134(4): 1051 - 1052. [Full Text] [PDF]

				A. Mitra, J. Spears, V. Perrotta, J. McClurkin, and A. Mitra Salvage of Infected Prosthetic Grafts of the Great Vessels via Muscle Flap Reconstruction Chest, August 1, 2005; 128(2): 1040 - 1043. [Abstract] [Full Text] [PDF]

				R. Erbel, F. Alfonso, C. Boileau, O. Dirsch, B. Eber, A. Haverich, H. Rakowski, J. Struyven, K. Radegran, U. Sechtem, et al. Diagnosis and management of aortic dissection: Task Force on Aortic Dissection, European Society of Cardiology Eur. Heart J., September 2, 2001; 22(18): 1642 - 1681. [PDF]

				D. W. Mathes, M. J. Yaremchuk, E. M. Isselbacher, and J. C. Madsen Successful in situ treatment of an infected ascending aortic graft Ann. Thorac. Surg., October 1, 2000; 70(4): 1410 - 1412. [Abstract] [Full Text] [PDF]

				J. S. Coselli, C. Koksoy, and S. A. LeMaire Management of thoracic aortic graft infections Ann. Thorac. Surg., June 1, 1999; 67(6): 1990 - 1993. [Abstract] [Full Text] [PDF]

				N. Nakajima, M. Masuda, M. Ichinose, and M. Ando A new method for the treatment of graft infection in the thoracic aorta: in situ preservation Ann. Thorac. Surg., June 1, 1999; 67(6): 1994 - 1996. [Abstract] [Full Text] [PDF]

				J. H. Palma, W. J. Gomes, D. R. Almeida, A. C. Carvalho, L. A. Brasil, and E. Buffolo Replacement of Infected Thoracic Aortic Prosthesis With a Spiral Composite Vein Graft Ann. Thorac. Surg., April 1, 1998; 65(4): 1135 - 1137. [Abstract] [Full Text] [PDF]

				O. Chavanon, F. Thony, J. Lebeau, and D. Blin Exposed prosthesis of a complex reconstruction of the ascending aorta and aortic arch in a sternal wound infection: Successful treatment by a pectoral muscle flap Eur. J. Cardiothorac. Surg., January 1, 1998; 13(1): 98 - 100. [Abstract] [Full Text] [PDF]