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The Journal of Cardiovascular Surgery 2014 October;55(5):693-8


lingua: Inglese

Mid- and long-term results after replacement of infected peripheral vascular prosthetic grafts with biosynthetic collagen prosthesis

Wiltberger G. 1, Matia I. 1, Schmelzle M. 1, 2, Krenzien F. 1, Hau H. M. 1, Freitas B. 1, Jonas S. 1, Fellmer P. T. 1

1 Department of Visceral-, Transplantation-, Thoracic-, and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany; 2 Translational Centre for Regenerative Medicine, University of Leipzig, Germany


AIM: We assess mid- and long-term outcome after prosthetic graft replacement with biosynthetic collagen prosthesis (Omniflow II®) in the presence of graft infection.
METHODS: Between December 2010 and January 2012, an analysis of 9 consecutive patients was performed, who underwent replacement of an infected peripheral graft with a biosynthetic prosthesis. Morbidity, in-hospital mortality, primary and secondary patency were analyzed. FDG-PET was performed to diagnose graft infection, and exclude reinfection at long-term follow-up.
RESULTS: Graft infection occurred after a median of 12 (range 3-97) months after the initial procedure. Replacement surgery was performed successfully in all 9 patients without intraoperative complications. Microbiological cultures revealed pathogenic infection in 7 cases. In 2 patients, no pathogen was isolated. The morbidity rate was 55.5% with no in-hospital deaths. Early and late bypass occlusion occurred in 2 patients. One high above-knee amputation was performed due to patient deterioration. The median length of stay was 23 (range 12-122) days and after graft replacement 13 (range 10-62) days. The median time of follow up was 23 (range 8-25) months. Primary and secondary patency rates were 66.6% and 78% at 19 months, respectively. FDG-PET was performed in 6 (85.5%) patients after a median follow up period of 19 (range 3-23) months, and excluded graft reinfection in all patients.
CONCLUSION: Replacement of infected peripheral prosthetic grafts with the prosthesis (Omniflow II®) has encouraging results. The collagen prosthesis appears to be a promising alternative with a low reocclusion rate and no reinfection.

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