Perigraft Seroma After Surgical Aortoiliac Aneurysm Repair with Knitted Polyester Grafts: Report of Two Cases

Kondo, Yuka; Muto, Akihito; Dardik, Alan; Nishibe, Masayasu; Nishibe, Toshiya

doi:10.3400/avd.cr08010

Cited by 12 publications

(8 citation statements)

References 4 publications

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“…PGS can be devastating as it can cause secondary graft infection, and PGS symptoms can vary depending on the site of formation. An asymptomatic mass [ 2 ], pain, acute limb ischemia secondary to graft limb compression, and respiratory distress have been reported [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Expanding perigraft seroma after ascending aorta replacement

Kanemitsu

Sakamoto

Teranishi

et al. 2022

J Cardiothorac Surg

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Background Perigraft seroma is a persistent and sterile fluid confined within a fibrous pseudomembrane surrounding a graft that develops after graft replacement. Development of perigraft seroma is an uncommon complication that occurs after the surgical repair of the thoracic aorta using woven polyester grafts. mechanism underlying perigraft seroma formation remains unclear. Case presentation Herein, we describe the case of 77-year-old man who underwent repeat sternotomy for the treatment of large perigraft seroma 1 year after ascending aorta replacement for acute type A dissection. After removing a cloudy yellow fluid, we covered the prosthetic graft with fibrin glue and wrapped it with a new graft. Bacterial culture and laboratory examination of the fluid confirmed the final diagnosis of perigraft seroma, and there was no evidence of recurrence. The area in which fluid accumulated around the graft shrunk 1 year after surgery. Conclusions The cause of a expanding perigraft after repair of the thoracic aorta remains unknown. Physicians should be aware that chronic expanding mediastinal seroma with Dacron grafts is one of the rare postoperative complications of thoracic aortic surgery. Applying fibrin glue to the graft surface might effectively prevent the recurrence of perigraft seroma.

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Section: Discussionmentioning

confidence: 99%

Expanding perigraft seroma after ascending aorta replacement

Kanemitsu

Sakamoto

Teranishi

et al. 2022

J Cardiothorac Surg

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“…The cause of PGS is uncertain, but several hypotheses have been proposed, including immunologic response, low-grade infection, and fluid discharge through the graft. Biological reactions against the graft may also be a cause of PGS, and graft materials have also been reported to be related to PGS, including Dacron grafts 12) , polytetrafluoroethylene 11) , and polyester 13) . Treatments for PGS include discontinuation of antiplatelet therapy after open surgical repair of abdominal aortic aneurysm 13) , endovascular therapy 14) , wrapping the Surgicel around the graft 15) , omental flap coverage 16) , and graft replacement.…”

Section: Discussionmentioning

confidence: 99%

“…Biological reactions against the graft may also be a cause of PGS, and graft materials have also been reported to be related to PGS, including Dacron grafts 12) , polytetrafluoroethylene 11) , and polyester 13) . Treatments for PGS include discontinuation of antiplatelet therapy after open surgical repair of abdominal aortic aneurysm 13) , endovascular therapy 14) , wrapping the Surgicel around the graft 15) , omental flap coverage 16) , and graft replacement. Conversely, in cases of bacterial biofilm infections of vascular prostheses, the bacteria adhere to the prosthesis and proceed by the excision of the infected grafts 17) .…”

Section: Discussionmentioning

confidence: 99%

Sterile Abscess with Mediastinal Cutaneous Fistula After Total Aortic Replacement

Kawarazaki

Inafuku

Numajiri

2022

International Journal of Surgical Wound Care

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A sterile abscess around a prosthesis or perigraft seroma is rare but sometimes occurs in a perigraft after reconstructive surgery. Removal of the causative graft is the favored treatment, but in some cases, this cannot be performed, and there is a reluctance to treat the abscess due to the risk to the patient. Herein, we report a case treated with total aortic replacement and omental flap reconstruction, after which the fistula-forming sterile abscess did not resolve. Major pectoral muscle flap reconstruction around the fistula was then conducted, but this surgery did not improve fistula discharge, and a new fistula appeared at the fragile site of the chest. This outcome suggests that fistula and perigraft repairs are required in such cases.

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“…1–4 In our case, we speculate that the PGS resulted from both the inflammation around the aneurysm wall and fibrin leakage from the PTFE graft. Following the surgery for esophageal cancer, there was severe adhesion of the aneurysmal wall to the IVC which was very near to contained rupture, 5 so inflammatory lesions were extremely close to the graft after incomplete resection of the aneurysmal wall. We could not remove all of the PTFE graft at the second surgery due to the strong adhesions around the IVC.…”

Section: Discussionmentioning

confidence: 99%

Perigraft seroma with minute observations after Gore-Tex graft implantation

Ando

Morito

Okada

et al. 2014

Asian Cardiovasc Thorac Ann

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Perigraft seroma is a very rare postoperative complication following abdominal aortic aneurysm repair. A 74-year-old man with history of esophageal cancer surgery, underwent Gore-Tex graft replacement for an abdominal aortic aneurysm. A 50-mm perigraft seroma was noted one year later, increasing to over 70 mm in the next 6 months. We resected the Gore-Tex graft and replaced it with a Dacron graft via a repeat laparotomy. We observed the resected Gore-Tex graft in detail using electron microscopy to investigate the mechanism of perigraft seroma.

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Perigraft Seroma After Surgical Aortoiliac Aneurysm Repair with Knitted Polyester Grafts: Report of Two Cases

Cited by 12 publications

References 4 publications

Expanding perigraft seroma after ascending aorta replacement

Expanding perigraft seroma after ascending aorta replacement

Sterile Abscess with Mediastinal Cutaneous Fistula After Total Aortic Replacement

Perigraft seroma with minute observations after Gore-Tex graft implantation

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