Management of thoracic aortic graft infections

Ann Thorac Surg. 1999 Jun;67(6):1990-3; discussion 1997-8. doi: 10.1016/s0003-4975(99)00355-0.


Background: We reviewed our experience managing patients with thoracic aortic graft infections to evaluate their clinical characteristics and outcomes of treatment.

Methods: Records of 20 consecutive patients with thoracic aortic graft infections managed over a 7 year period were retrospectively reviewed. Current follow-up status was obtained for all survivors. RESULTS; Nineteen patients (95%) underwent surgical treatment. Graft excision and in situ replacement were performed using Dacron grafts (10/19, 53%) or cryopreserved homografts (5/19, 26%). Three pseudoaneurysms were managed by debridement and primary repair. Although 30 day postoperative survival was 89% (17/19), in-hospital mortality occurred in 8 patients (42%). Infected thoracoabdominal aortic grafts were universally fatal. Of 6 patients with infected composite valve grafts, both patients who received new composite valve grafts died and all 4 who received homografts survived (p = 0.067).

Conclusions: Infections involving thoracic aortic grafts continue to carry a high mortality rate, especially in patients with polymicrobial infections, thoracoabdominal aortic graft infections, and composite valve graft infections. Use of homografts in the latter situation may improve outcome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Aorta, Thoracic* / surgery
  • Aortic Aneurysm / surgery*
  • Aortic Aneurysm, Thoracic / surgery
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis Implantation*
  • Cryopreservation
  • Debridement
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prosthesis-Related Infections / surgery*
  • Retrospective Studies
  • Transplantation, Homologous