Skip to main content
SpringerLink
Log in

Management of Infected Grafts and Aneurysms of the Aorta

  • Published:
Annals of Vascular Surgery

Abstract

Seventeen patients treated for infected grafts (11/17) or aneurysms (6/17) of the aorta between 1998 and 2003 were reviewed to evaluate our experience with aortic infection. The causative organisms were identified in 12 patients (71%), with 5 (29%) having methicillin-resistant Staphylococcus aureus. A periaortic abscess occurred in eight patients, and all of them were associated with infected grafts. Surgical treatment included cryopreserved allograft replacement in eight patients, prosthetic graft replacement in four patients, and drainage with or without omental wrapping in five patients. One patient was still hospitalized at the end of the study period. Five patients with infected grafts died after the operation during the initial hospitalization. No early mortality occurred in the aneurysm group. The early mortality rate was 31% for all patients, 50% for the graft group, and 63% for patients with a periaortie abscess. Another patient with an infected aneurysm died of arrhythmia after discharge from the initial hospitalization, Ten patients are still alive without evidence of reinfection. The early mortality rate for patients with infected aortic grafts is higher than that for those with infected aneurysms, especially when a periaortic abscess accompanies them. However, the late outcome is favorable, with no reinfection or late treatment-related deaths.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. JJ Ricotta GL Faggioli A Stella et al. (1991) ArticleTitleTotal excision and extra-anatomic bypass for aortic graft infection Am J Surg 162 145–149 Occurrence Handle1:STN:280:DyaK3MzitV2gtA%3D%3D Occurrence Handle1862835

    CAS  PubMed  Google Scholar 

  2. WJ Quinones Baldrich JJ Hernandez WS Moore (1991) ArticleTitleLong-term results following surgical management of aortic graft infection Arch Surg 126 507–511 Occurrence Handle1:STN:280:DyaK3M7otF2qug%3D%3D Occurrence Handle2009068

    CAS  PubMed  Google Scholar 

  3. RA Yeager GL Moneta LM Taylor SuffixJr et al. (1990) ArticleTitleImproving survival and limb salvage in patients with aortic graft infection, Am J Surg 159 466–469 Occurrence Handle1:STN:280:DyaK3c3ktVCksg%3D%3D Occurrence Handle2334008

    CAS  PubMed  Google Scholar 

  4. E Kieffer A Bahnini C Ruotolo et al. (1993) ArticleTitleIn situ allograft replacement of infected infrarenal aortic prosthetic grafts: results in forty-three patients J Vasc Surg 17 349–356 Occurrence Handle1:STN:280:DyaK3s7msVehtQ%3D%3D Occurrence Handle8433430

    CAS  PubMed  Google Scholar 

  5. G Lesèche Y Castier MD Petit et al. (2001) ArticleTitleLong-term results of cryopreserved arterial allograft reconstruction in infected prosthetic grafts and mycotic aneurysms of the abdominal aorta J Vasc Surg. 34 616–622 Occurrence Handle11668314

    PubMed  Google Scholar 

  6. PR Vogt HP Brunner-LaRocca M Lachat et al. (2002) ArticleTitleTechnical details with the use of cryopreserved arterial allografts for aortic infection: influence on early and midterm mortality J Vasc Surg 35 80–86 Occurrence Handle11802136

    PubMed  Google Scholar 

  7. AA Noel P Gloviczki KJ Cherry SuffixJr et al. (2002) ArticleTitleAbdominal aortic reconstruction in infected fields: early results of the United States cryopreserved aortic allograft registry J Vasc Surg 35 847–852 Occurrence Handle12021697

    PubMed  Google Scholar 

  8. H Arbatli R DeGeest E Demirsoy et al. (2003) ArticleTitleManagement of infected grafts and mycotic aneurysms of the aorta using cryopreserved homografts Cardiovasc Surg 11 257–263 Occurrence Handle12802260

    PubMed  Google Scholar 

  9. R Verhelst V Lacroix H Vraux et al. (2000) ArticleTitleUse of cryopreserved arterial homografts for management of infected prosthetic grafts: a multicentric study Ann Vasc Surg 14 602–607 Occurrence Handle1:STN:280:DC%2BD3M7hsValtw%3D%3D Occurrence Handle11128454

    CAS  PubMed  Google Scholar 

  10. E Kieffer J Sabatier D Plissonnier et al. (2001) ArticleTitleProsthetic graft infection after descending thoracic/thoracoabdominal aortic aneurysmectomy: management with in situ arterial allografts J Vasc Surg 33 671–678 Occurrence Handle1:STN:280:DC%2BD3M3kvVeksg%3D%3D Occurrence Handle11296316

    CAS  PubMed  Google Scholar 

  11. JE Lorentzen OM Nielsen H Arendrup et al. (1985) ArticleTitleVascular graft infection: an analysis of sixty-two graft infections in 2411 consecutively implanted synthetic vascular grafts Surgery 98 81–86 Occurrence Handle1:STN:280:DyaL2M3ksFahtg%3D%3D Occurrence Handle4012610

    CAS  PubMed  Google Scholar 

  12. GS Oderich JM Panneton TC Bower et al. (2001) ArticleTitleInfected aor- tic aneurysm: aggressive presentation, complicated early outcome, but durable results J Vasc Surg 34 900–908 Occurrence Handle1:STN:280:DC%2BD3MnkvVSjsQ%3D%3D Occurrence Handle11700493

    CAS  PubMed  Google Scholar 

  13. LG Svensson ES Crawford KR Hess et al. (1993) ArticleTitleExperience with 1509 patients undergoing thoracoabdominal aortic opertions J Vasc Surg 17 357–370 Occurrence Handle1:STN:280:DyaK3s7msVehug%3D%3D Occurrence Handle8433431

    CAS  PubMed  Google Scholar 

  14. J Rydberg KK Kopecky MS Johnson et al. (2001) ArticleTitleEndovascular repair of abdominal aortic aneurysms: assessment with multislice CT AJR Am J Roentgenol 177 607–614 Occurrence Handle1:STN:280:DC%2BD3MvntFKrug%3D%3D Occurrence Handle11517055

    CAS  PubMed  Google Scholar 

  15. M Prokop CT Multislice (2000) ArticleTitleangiography Eur J Radiol 36 86–96 Occurrence Handle10.1016/S0720-048X(00)00271-0 Occurrence Handle1:STN:280:DC%2BD3M7ht1GitA%3D%3D Occurrence Handle11116172

    Article  CAS  PubMed  Google Scholar 

  16. K Daenens I Fourneau A Nevelsteen (2003) ArticleTitleTen-year experience in autogenous reconstruction with the femoral vein in the treatment of aortofemoral prosthetic infection Eur J Vasc Endovasc Surg 25 240–245 Occurrence Handle12623336 Occurrence Handle1:STN:280:DC%2BD3s7htVGhug%3D%3D

    PubMed  CAS  Google Scholar 

  17. OA Goeau-Brissonniere D Fabre V Leflon-Guibout et al. (2002) ArticleTitleComparison of the resistance to infection of rifampin-bonded gelatin-sealed and silver/collagen-coated polyester prostheses J. Vasc. Surg. 35 1260–1263 Occurrence Handle12042739

    PubMed  Google Scholar 

  18. RM Young KJ Cherry SuffixJr PM Davis et al. (1999) ArticleTitleThe results of in situ prosthetic replacement for infected aortic grafts Am J Surg 178 136–140 Occurrence Handle1:STN:280:DyaK1MvhsFWrug%3D%3D Occurrence Handle10487266

    CAS  PubMed  Google Scholar 

  19. GP Clagett RJ Valentine RT Hagino (1997) ArticleTitleAutogenous aortoiliac/femoral reconstruction from superficial femoral-popliteal veins: feasibility and durability J Vasc Surg 25 255–270 Occurrence Handle1:STN:280:DyaK2s3gsFSmsQ%3D%3D Occurrence Handle9052560

    CAS  PubMed  Google Scholar 

  20. FY Chan ES Crawford JS Coselli et al. (1989) ArticleTitleIn situ prosthetic graft replacement for mycotic aneurysm of the aorta Ann Thorac Surg 47 193–203 Occurrence Handle1:STN:280:DyaL1M7kvFWrtQ%3D%3D Occurrence Handle2919901 Occurrence Handle10.1016/0003-4975(89)90268-3

    Article  CAS  PubMed  Google Scholar 

  21. F Koskas O Goeau-Brissonniere MN Nicolas et al. (1996) ArticleTitleArteries from human beings are less infectible by Staphylococcus aureus than polytetrafluoroethylene in an aortic dog model J Vasc Surg 23 472–476 Occurrence Handle1:STN:280:DyaK287ot1Ggtw%3D%3D Occurrence Handle8601890

    CAS  PubMed  Google Scholar 

  22. PR Vogt T Stallmach U Niederhäuser et al. (1999) ArticleTitleExplanted cryopreserved allografts: a morphological and immunohistochemicl comparison between arterial allografts and allograft heart valves from infants and adults Eur J Cardiothorac Surg 15 639–645 Occurrence Handle10386410 Occurrence Handle1:STN:280:DyaK1Mzht12rsw%3D%3D

    PubMed  CAS  Google Scholar 

  23. FB Oei AP Stegmann LM Vaessen et al. (2001) ArticleTitleImmunological aspects of fresh and cryopreserved aortic valve transplantation in rats Ann Thorac Surg 71 S379–S384 Occurrence Handle1:STN:280:DC%2BD3MzhsVynsQ%3D%3D Occurrence Handle11388229

    CAS  PubMed  Google Scholar 

  24. E Szilagyi F Rodriguez R Smith et al. (1970) ArticleTitleLate fate of arterial allografts Arch Surg 101 721–733 Occurrence Handle1:STN:280:DyaE3M%2FmtlWjtQ%3D%3D Occurrence Handle5489297

    CAS  PubMed  Google Scholar 

  25. MF O’Brien S Harrocks EG Stafford et al. (2001) ArticleTitleThe homograft aortic valve: a 29-year, 99.3% follow up of 1,022 valve replacements J Heart Valve Dis 10 334–344 Occurrence Handle1:STN:280:DC%2BD3M3psF2ksw%3D%3D Occurrence Handle11380096

    CAS  PubMed  Google Scholar 

  26. AR Naylor (1999) ArticleTitleAortic prosthetic infection Br J Surg 86 435–436 Occurrence Handle10215810

    PubMed  Google Scholar 

  27. RS Dieter AK Patel D Yandow et al. (2003) ArticleTitleConservative vs. invasive treatment of aortocoronary saphenous vein graft aneurysms: treatment algorithm based upon a large series Cardiovasc. Surg 11 507–513 Occurrence Handle14627974

    PubMed  Google Scholar 

  28. BM Stanley JB Semmens MM Lawrence-Brown et al. (2003) ArticleTitleEndoluminal repair of mycotic thoracic aneurysms J. Endovasc. Ther 10 511–515 Occurrence Handle12932162

    PubMed  Google Scholar 

  29. JS Coselli ES Crawford TW Williams et al. (1990) ArticleTitleTreatment of postoperative infection of ascending aorta and transverse arch, including use of viable omentum and muscle flaps Ann. Thorac. Surg 50 868–881 Occurrence Handle1:STN:280:DyaK3M%2FltlCnsQ%3D%3D Occurrence Handle2241378 Occurrence Handle10.1016/0003-4975(90)91111-N

    Article  CAS  PubMed  Google Scholar 

  30. JS Coselli S Büket ES Crawford (1996) Thoracic aortic aneurysms H editor Haimovici (Eds) Vascular Surgery EditionNumber4 Blackwell Science Cambridge 759–785

    Google Scholar 

  31. ML McLaws PC Taylor (2003) ArticleTitleThe Hospital Infection Standardised Surveillance (HISS) programme: analysis of a two-year pilot J Hosp Infect 53 259–267 Occurrence Handle12660122

    PubMed  Google Scholar 

  32. MT Albertini C Benoit L Berardi et al. (2002) ArticleTitleMicrobiology Surveillance Network of Northern France: surveillance of methicillin-resistant Staphylococcus aureus (MRSA) and Enterobacteriaceae producing extended-spectrum beta-lactamase (ESBLE) in northern France: a five-year multicentre incidence study J Hosp Infect 52 107–113 Occurrence Handle1:STN:280:DC%2BD38njvVCksg%3D%3D Occurrence Handle12398076

    CAS  PubMed  Google Scholar 

  33. M Carrier R Marchand P Auger et al. (2002) ArticleTitleMethicillin-resistant Staphylococcus aureus infection in a cardiac surgical unit J Thorac Cardiovasc Surg 123 40–44 Occurrence Handle11782754

    PubMed  Google Scholar 

  34. M Melzer SJ Eykyn WR Gransden et al. (2003) ArticleTitleIs methicillin-resistant Staphylococcus aureus more virulent than methicillin-susceptible S.aureus? Clin Infect Dis 37 1453–1460 Occurrence Handle1:STN:280:DC%2BD3srjsFKgsA%3D%3D Occurrence Handle14614667

    CAS  PubMed  Google Scholar 

  35. AR Naylor PD Hayes S Darke (2001) ArticleTitleA prospective audit of complex wound and graft infections in Great Britain and Ireland: the emergence of MRSA Eur J Vasc Endovasc Surg 21 289–294 Occurrence Handle11359327 Occurrence Handle1:STN:280:DC%2BD3M3nsFymtA%3D%3D

    PubMed  CAS  Google Scholar 

  36. S Chang DM Sievert JC Hageman et al. (2003) ArticleTitleVancomycin-resistant Staphylococcus aureus Investigative Team: infection with vancomycin-resistant Staphylococcus aureus containing the vanA resistance gene N Engl J Med 348 1342–1347 Occurrence Handle12672861

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiothoracic Surgery, The University of Tokyo Hospital, Tokya, Japan

    Tadashi Kitamura MD, Tetsuro Morota MD, Noboru Motomura MD, Minoru Ono MD, Ko Shibata MD, Katsuhito Ueno MD, Yutaka Kotsuka MD & Shinichi Takamoto MD

  2. Department of Cardiothoracic Surgery, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan

    Tadashi Kitamura MD

Authors
  1. Tadashi Kitamura MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tetsuro Morota MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Noboru Motomura MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Minoru Ono MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ko Shibata MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Katsuhito Ueno MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yutaka Kotsuka MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Shinichi Takamoto MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tadashi Kitamura MD.

About this article

Cite this article

Kitamura, T., Morota, T., Motomura, N. et al. Management of Infected Grafts and Aneurysms of the Aorta. Ann Vasc Surg 19, 335–342 (2005). https://doi.org/10.1007/s10016-005-0006-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10016-005-0006-4

Keywords

Search

Navigation