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

Copyright © 2009 EDIZIONI MINERVA MEDICA

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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