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J Thorac Cardiovasc Surg 2007;134:1051-1052
© 2007 The American Association for Thoracic Surgery

Brief Communication

Management of prosthetic graft infection after surgery of the thoracic aorta: Removal of the prosthetic graft is not necessary

Department of Cardiothoracic Surgery, Bristol Heart Institute at The Bristol Royal Infirmary, Bristol, United Kingdom.

Received for publication February 9, 2007; accepted for publication February 23, 2007.

^_* Address for reprints: Alan J. Bryan DM, FRCS (C/Th), Consultant Cardiac Surgeon, Bristol Heart Institute, Bristol Royal Infirmary, Upper Maudlin Street, Bristol BS2 8HN. (Email: Alan.Bryan@ubht.swest.nhs.uk).

The first 20% of the full text of this article appears below.

Prosthetic graft infection (PGI) after surgery to reconstruct the thoracic aorta is a devastating complication. The reported incidence is between 1% and 3%.¹ Treatment of this complication remains a challenge for surgeons, and chances of a successful outcome are considered low. Mortality rates range from 25% to 75%, and morbidity in surviving patients is high.²

Most reports advocate a management strategy that combines removal of all the prosthetic material, removal of surrounding tissue, and extra-anatomic arterial reconstruction.^3-5 However, such a major surgical undertaking may not be possible in most cases because of the technically challenging nature of the surgery, and because most patients usually have multiorgan dysfunction caused by sepsis, making the procedure risky.

In this report, we define the outcome and management strategies for PGI after surgery to reconstruct the thoracic aorta. We report our experience of managing PGI with a more conservative approach.

Clinical Summary

From 1996 to 2005, . . . [Full Text of this Article]

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