Annals of Vascular Surgery

, Volume 5, Issue 6, pp 538–541 | Cite as

Replacement of the abdominal aorta with an aortic homograft in a patient with an aortic dissection

  • John B. Steinberg
  • Samuel A. Nickell
  • M. Alex Jacocks
  • Paul Stelzer
Case Reports


The use of aortic and femoral homografts in early vascular surgery has been abandoned for the more successful and abundant synthetic substitutes. With the recent introduction of cryopreservation, homograft use has again met with improved success. A 40-year-old man who had a DeBakey Type I aortic dissection initially underwent replacement of the aortic root with a pulmonary homograft. Subsequently, in the presence of an intraabdominal infectious process, progressive mesenteric and lower limb ischemia was treated by replacing the abdominal aorta with an aortic homograft. Thirty-six months postoperative the patient has a functioning gastrointestinal tract and no vascular insufficiency of the lower extremities and no evidence of degeneration of the homograft. Further laboratory studies should be undertaken using the newer and improved cyropreserved homograft in the presence of, or potential for, an intraabdominal infectious process.

Key words

Abdominal aorta homograft cryopreservation aortic dissection ischemia 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    GROSS RE, HURWITT ES, BILL AH, et al. Preliminary observations on the use of human arterial grafts in the treatment of certain cardiovascular defects.N Engl J Med 1948;239:578–579.Google Scholar
  2. 2.
    OUDOT J, BEACONSFIELD P. Thrombosis of the aortic bifurcation treated by resection and homograft replacement.Arch Surg 1953;66:365–374.Google Scholar
  3. 3.
    DUBOST C, ALLARY M, OECONOMOS N. Resection of an aneurysm of the abdominal aorta. Reestablishment of the continuity by a preserved human arterial graft, with result after five months.Arch Surg 1952;64:405–408.Google Scholar
  4. 4.
    STELZER P, ELKINS RE. Homograft valves and conduits: applications in cardiac surgery.Curr Prob Surg 1989;26:383–452.Google Scholar
  5. 5.
    DUBOST C. The first successful resection of an aneurysm of the abdominal aorta followed by re-establishment of continuity using a preserved human arterial graft.Ann Vasc Surg 1986;1:147–149.PubMedGoogle Scholar
  6. 6.
    SMULLENS SN, TEMPLETON JY. Eight year patency of abdominal aortic homograft.Am J Surg 1970;120:116–118.PubMedGoogle Scholar
  7. 7.
    BROCK L. Long term success with homograft reconstruction of the aorta for the cure of aneurysm.Guy's Hosp Reports 1973:122:129–134.Google Scholar
  8. 8.
    DE BAKEY ME, CRAWFORD ES, COOLEY DA, et al. Surgical considerations of occlusive disease of the abdominal aorta and iliac and femoral arteries: analysis of 803 cases.Ann Surg 1958;148:306–324.PubMedGoogle Scholar
  9. 9.
    SZILAGYI DE, MCDONALD RT, SMITH RF, et al. Biologic fate of human arterial homografts.Arch Surg 1957;75:506–529.Google Scholar
  10. 10.
    SZILAGYI DE, RODRIQUEZ FJ, SMITH RF, et al. Late fate of arterial allografts: observations 6 to 15 years after implantation.Arch Surg 1970;101:721–733.PubMedGoogle Scholar
  11. 11.
    DEBAKEY ME, COOLEY DA, CRAWFORD ES, et al. Clinical application of a new flexible knitted dacron arterial substitute.Am Surg 1958;24:862–869.PubMedGoogle Scholar
  12. 12.
    EDWARDS WH, MARTIN RS, JENKINS JM, et al. Primary graft infections.J Vasc Surg 1987;6:235–239.PubMedGoogle Scholar
  13. 13.
    LORENTZEN JE, NIELSEN OM, ARENDRUP H, et al. Vascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts.Surgery 1985;98:81–86.PubMedGoogle Scholar
  14. 14.
    YEAGER RA, MC CONNELL DB, SASAKI TM, et al. Aortic and peripheral prosthetic graft infection: differential management and causes of mortality.Am J Surg 1985;150:36–43.PubMedGoogle Scholar
  15. 15.
    DOSCHER W, KRISHNASASTRY KV, DECKOFF SL. Fungal graft infections: case report and review of the literature.J Vasc Surg 1987;6:398–402.PubMedGoogle Scholar
  16. 16.
    BIRINYI LK, DOUVILLE EC, LEWIS SA, et al. Increased resistance to bacteremic graft infection after endothelial cell seeding.J Vasc Surg 1987;5:193–197.PubMedGoogle Scholar
  17. 17.
    RICH NM, HUGHES CW. The fate of prosthetic material used to repair vascular injuries in contaminated wounds.J Trauma 1972;12:459–467.PubMedGoogle Scholar
  18. 18.
    EHRENFELD WK, WILBUR BG, OLCOTT CN, et al. Autogenous tissue reconstruction in the management of infected prosthetic grafts.Surgery 1979:85:82–92.PubMedGoogle Scholar
  19. 19.
    SEEGER JM, WHEELER JR, GREGORY RT, et al. Autogenous graft replacement of infected prosthetic grafts in the femoral position.Surgery 1983;93:39–45.PubMedGoogle Scholar
  20. 20.
    ZWISCHENBERGER JB, SHALABY TZ, CONTI VR. Viable cryopreserved aortic homograft for aortic valve endocarditis and annular abscesses.Ann Thorac Surg 1989;48:365–370.PubMedGoogle Scholar
  21. 21.
    TUNA IL, ORSZULAK TA, SCHAFF HV, et al. Results of homograft aortic valve replacement for active endocarditis.Ann Thorac Surg 1990;49:619–624.PubMedGoogle Scholar
  22. 22.
    MATSUKI O, ROBLES A, GIBBS S, et al. Long-term performance of 555 aortic homografts in the aortic position.Ann Thorac Surg 1988:46:187–191.PubMedGoogle Scholar
  23. 23.
    JAMES R, HAYMAN JA. Fatal dissecting aneurysm of the aorta in a diver.Pathology 1986;18:345–347.PubMedGoogle Scholar
  24. 24.
    GROSS RE, BILL AH, PIERCE EC. Methods for preservation and transportation of arterial grafts: observations on arterial grafts in dogs. Report of transplantation of preserved arterial grafts in nine human cases.Surg Gynecol & Obstet 1949:88:689–701.Google Scholar
  25. 25.
    YACOUB M, KITTLE CF. Sterilization of valve homografts by antibiotic solutions.Circulation 1970;41 (Suppl II):29–32.Google Scholar
  26. 26.
    ROSS DN. Homograft replacement of the aortic valve.J Cardiovasc Surg 1965;Suppl:89–94.Google Scholar
  27. 27.
    BARRATT-BOYES GB. A method for preparing and inserting a homograft aortic valve.Br J Surg 1965;52:847–856.PubMedGoogle Scholar
  28. 28.
    MALM JR, BOWMAN FO, HARRIS PD, et al. An evaluation of aortic valve homograft sterilized by electron beam energy.J Thorac Cardiovasc Surg 1967;54:471–477, 486–490.PubMedGoogle Scholar
  29. 29.
    BEACH PM, BOWMAN FO, KAISER GA, et al. Aortic valve replacement with frozen irradiated homografts: long term evaluation.Circulation 1972;45 (Suppl I):29–35.Google Scholar
  30. 30.
    O'BRIEN MF, STAFFORD EG, GARDNER MAH, et al. A comparison of aortic valve replacement with viable cryopreserved and fresh allograft valves, with a note on chromosomal studies.J Thorac Cardiovasc Surg 1987;94:812–823.PubMedGoogle Scholar
  31. 31.
    JONES DJ, HANCE ML, STELZER P, et al. Procurement of hearts for valve homografts: one year's experience.J Okla State Med Assoc 1988;81:510–512.PubMedGoogle Scholar

Copyright information

© Annals of Vascular Surgery Inc. 1991

Authors and Affiliations

  • John B. Steinberg
    • 1
  • Samuel A. Nickell
    • 1
  • M. Alex Jacocks
    • 1
  • Paul Stelzer
    • 1
    • 2
  1. 1.Department of SurgeryUniversity of Oklahoma Health Sciences CenterOklahoma City
  2. 2.Department of Cardiothoracic SurgeryLenox Hill HospitalNew York

Personalised recommendations