| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Ann Thorac Surg 1999;67:1994-1996
© 1999 The Society of Thoracic Surgeons
a First Department of Surgery and Plastic Surgery, School of Medicine, Chiba University, Chiba, Japan
b Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan
Address reprint requests to Dr Nakajima, First Department of Surgery, School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba City, Chiba, 260 Japan
Presented at the Aortic Surgery Symposium VI, April 30–May 1, 1998, New York, NY.
Background. We have developed a new method to control graft infection by a combination of two procedures, extensive disinfection followed by tissue flap implantation, allowing preservation of the original graft.
Method. Soon after the diagnosis of graft infection was confirmed, the wound was re-explored, and debridement, irrigation and packing with sponges soaked with 10% iodine solution were employed. This procedure was repeated every 8 hours for the first 48 hours. For the second step, tissue flaps using omentum or muscle were implanted around the graft as well as in dead space, and the wound was closed primarily.
Materials. A total of 6 patients were treated: 4 in the acute and 2 in the chronic phase of infection. The original procedures were a Bentall procedure + arch replacement (1), ascending aorta replacement + arch (3) and replacement of the descending aorta (2). In descending aorta cases, an extended thoracoplasty was concomitantly added to eliminate dead space in the pleural cavity.
Results. Graft infections were controlled in all 6 patients. One hospital death unrelated to infection was encountered. Five patients were discharged, but 1 died of a stent-graft complication. The follow-up period ranged from 4 months to 10 years.
Conclusion. Our method of extensive disinfection followed by tissue flap coverage of the graft proved to be highly effective in controlling the serious complication of graft infection associated with surgery of the thoracic aorta.
This article has been cited by other articles:
|
|
 |
|
  H. Sakaguchi, A. Marui, K. Hirose, T. Nomura, Y. Arai, S. C. Bir, Y. Huang, J. Esaki, Y. Tabata, T. Ikeda, et al. Less-invasive and highly effective method for preventing methicillin-resistant Staphylococcus aureus graft infection by local sustained release of vancomycin J. Thorac. Cardiovasc. Surg., January 1, 2008; 135(1): 25 - 31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. R. Brinster, R. J. Rizzo, and R. M. Bolman III Ascending Aortic Aneurysms Card. Surg. Adult, January 1, 2008; 3(2008): 1223 - 1250. [Full Text]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 Y. Kuniyoshi, K. Koja, K. Miyagi, T. Uezu, S. Yamashiro, and K. Arakaki Graft for Mycotic Thoracic Aortic Aneurysm: Omental Wrapping to Prevent Infection Asian Cardiovasc Thorac Ann, March 1, 2005; 13(1): 11 - 16. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Anderson, R. J. Rizzo, and L. H. Cohn Ascending Aortic Aneurysms Card. Surg. Adult, January 1, 2003; 2(2003): 1123 - 1148. [Full Text]
|
|
|
|
 |
|
 Y. Kawachi, A. Nakashima, T. Onzuka, and T. Yamauchi False aneurysm of the ascending aorta concomitant with chronic mediastinitis after tube graft replacement in octogenarian Eur. J. Cardiothorac. Surg., September 1, 2002; 22(3): 450 - 453. [Abstract] [Full Text] [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]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
