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THE JOURNAL OF CARDIOVASCULAR SURGERY

Rivista di Chirurgia Cardiaca, Vascolare e Toracica


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The Journal of Cardiovascular Surgery 2000 Aprile;41(2):311-5

lingua: Inglese

Management of infected peripheral bypass by selective partial graft removal and arterial homograft insertion. Two case reports

Locati P., Socrate A. M., Costantini E., Maggiolo F. *

From the ­Divi­sion of Vas­cular Sur­gery
*Divi­sion of Infec­ti­vous Dis­eases Busto ­Arsizio Gen­eral Hos­pital, ­Busto ­Arsizio, ­Italy


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We ­present two ­cases of par­tial ­graft ­removal and cryo­pre­served arte­rial homo­graft inser­tion for treat­ment of ­patent axil­lo­bif­e­moral (AXB) poly­tet­ra­flu­o­roe­thy­lene (­PTFE) pros­thesis ­with infec­tion con­fined ­only to a ­part of the ­graft. In the ­first ­patient, infec­tion was con­fined to the ­left ­inguinal ­site; in the ­second, ­there was a cuta­neous fis­tula in the ­middle pros­thetic tho­racic ­tract. Nei­ther ­patient pre­sented ­signs of ­systemic ­sepsis and ­radio immu­no­log­ical ­tests ­were pos­i­tive ­only in a con­fined ­tract. ­After sur­gery, ­both ­patients ­showed ­early ­recovery and cur­rently (­mean ­follow-up 21-­month) ­they are dis­ease-­free. Selec­tive par­tial ­graft ­removal ­appears to ­give sat­is­fac­tory ­results and may ­reduce the ­risk of com­pli­ca­tions com­pared ­with ­total ­graft ­removal. More­over, arte­rial homo­graft ­shows ­greater resis­tance to infec­tion com­pared to allo­plastic mate­rials, ­when autol­o­gous ­veins are not avail­able and/or not suit­able.

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