Aortic Surgery for Aortic Graft Infections: Defining National Benchmarks for Standards of Care

Abstract

61%) underwent muscle flap cover of the FPV reconstruction. In-hospital/ 30-day mortality was 5.4% (2 of 37); one from respiratory failure 20 days postoperatively, and the second, a 93-year-old woman, after withdrawal of care at 24 hours. No patients required fasciotomy, and five wound hematomas required reoperation. Focal femoropopliteal vein thrombosis occurred in five limbs. Over a mean follow-up of 2.5 years (range, 0.03-13.3) 11 patients died of unrelated causes at a mean of 3.7 years (range, 0.2-10.6 years). Graft reintervention was required in seven patients during follow-up for graft thromboses (n ϭ 2) stenoses (n ϭ 2), and anastomotic false aneurysms (n ϭ 3). Apart from the latter, there was no other suggestion of graft reinfection in any patient. Major limb loss occurred in one patient at 6 months despite a patent graft. Long-term FPV harvest morbidity included mild leg swelling in 10 patients.Conclusions: Replacement of infected synthetic grafts/femoral arteries in the groin with FPV is safe and results in excellent limb preservation and freedom from reinfection. FPV should be considered the preferred conduit in good-risk patients with infection limited to the groin.