Abstract
Objectives
Aortic infections are an uncommon but life-threatening disease. The material of choice
for aortic reconstruction is still a matter of debate. The aim of this study is to
examine the short and mid-term outcomes in the treatment of abdominal aortic infections
using self-made bovine pericardium tube grafts.
Material and methods
This retrospective, single-center study collected all patients who underwent in situ
abdominal aortic reconstruction using self-made bovine pericardial tube grafts between
February 2020 and December 2021 in a tertiary care center. Patient comorbidities,
symptoms, radiological, bacteriological and peri-operative findings, as well as postoperative
outcomes were analyzed.
Results
Bovine pericardial aortic tube grafts were used in 11 patients (10 male, median age
68.7 years). Two patients presented a native aortic infection and nine had graft infections
(four bypass grafts, four endografts and a plurioperated patient who had undergone
both endovascular and open procedures). There were two emergent surgeries due to infectious
aneurysm ruptures. All patients were symptomatic and the most frequent clinical finding
was lumbar or abdominal pain (36%), followed by wound infection (27%) and fever (18%).
Seven bifurcated and four straight pericardial tube grafts were needed. Purulent drainage
was obtained around the previous graft or in the aneurysmal sac in 7 cases; intraoperative
cultures were positive in 6 cases (Gram + bacteria). Two patients died in the immediate
postoperative period (perioperative mortality 18%; urgent procedures 50%; scheduled
procedures 11%). One patient had a major complication due to bilateral SARS-CoV2 pneumonia.
There was one single reintervention to control hemostasis due to bleeding non-graft-related.
The median follow-up was 14.1 months (3-24 months).
Conclusions
Our preliminary experience in the treatment of abdominal aortic infections by in situ reconstrucción with self-made bovine pericardial tube grafts shows promising results.
These should be confirmed in the long term.
Keywords
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Article info
Publication history
Accepted:
February 5,
2023
Received in revised form:
January 9,
2023
Received:
September 15,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
All authors have read and approved the manuscript and there is no financial arrangement or other relationship that could be construed as a conflict of interest.
Identification
Copyright
© 2023 Published by Elsevier Inc.
