Secondary Aortoduodenal Fistulas: Value of Initial Axillofemoral Bypass

Bergeron, Patrice; Espinoza, Hugo; Rudondy, P; Ferdani, M; Martín, J. M. Revilla; Jausseran, J M; R, Courbier

doi:10.1007/bf02021769

Cited by 30 publications

(11 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The simplest approach to reconstruction is in situ graft replacement, which is far from being generally accepted for the management of graft infection, but can avoid the potential risk of an aortic stump blowout. The results of a total excision of the infected graft and in situ reconstruction with prosthetic grafts in the previous reports 3,5,[7][8][9][10]14,[27][28][29][30][31][32] are as follows: perioperative mortality, 0%-100%; major amputation, 0%-11%; new graft infection, 0%-100%; new graft failure, 0%-14% (Table 3A). This technique may carry an increased risk of a newly implanted graft infection; therefore, it is only indicated for properly selected patients with minimal or localized contamination, or with graft infection caused by low virulence bacteria, such as Staphylococcus epidermidis.…”

Section: Discussionmentioning

confidence: 93%

“…If there is a fear of limb loss resulting from graft excision, then an immediate reconstruction by an extra-anatomic bypass (traditional procedure) is indicated. The results of this traditional procedure have been reported to vary as follows: perioperative mortality, 0%-64%; major amputation, 0%-9%; new graft infection, 0%-33%; new graft failure, 0%-19%; aortic stump blowout, 0%-40% [6][7][8][9][10][11][12][13][14] (Table 2A). If there is no fear of limb loss, then a total graft excision alone is indicated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Treatment for Aortic Graft Infection

et al. 2001

View full text Add to dashboard Cite

Nine patients with an aortic graft infection presented after undergoing aortic grafting. Seven of 9 patients underwent an initial aortic reconstruction in our hospital. The incidence of aortic graft infection was 1.5% (7/456). There were 6 cases of paraprosthetic infection and 3 cases of aortointestinal fistulas. The treatments consisted of a complete graft excision and an axillofemoral bypass in 6 patients, a complete graft excision alone, a partial graft excision and a femorofemoral bypass, and the preservation of the graft with omental wrapping and irrigation in 1 each. Broad-spectrum antibiotics were intravenously administered to all patients and were then replaced by selective antibiotics for the responsible organisms. All surviving patients received antibiotics orally for 3-6 months. The early postoperative mortality rate was 11.1%. Aortoduodenal fistula occurred in 1 patient with graft excision alone. Graft thrombosis occurred in 2 patients with an axillofemoral bypass. No late graft infection or stump blowout occurred in any patient. We believe that a complete excision of the infected graft as well as the maintenance of distal tissue perfusion is necessary. However, based on the condition of the patient, the appearance of the operating field, and the difficulty of a repeat operation, we would like to stress the importance of selecting the best and safest treatment plan for each case.

show abstract

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Treatment for Aortic Graft Infection

et al. 2001

View full text Add to dashboard Cite

show abstract

“…Bergeron et al [5] reported six perioperative deaths among seven patients who received in situ operations. Hemodynamically unstable patients were represented at a rate of 58.3% in our study group, and bleeding was proven before surgical management in 87% of the patients (Table 6).…”

Section: Discussionmentioning

confidence: 98%

“…An analysis of SAEF outcomes has been impaired by their infrequent occurrence (1%) after open aortic reconstruction and by the fact that SAEFs account for a small fraction (20% to 25%) of the aortic graft infection presentations described in most studies [1,2]. The operative management of SAEF, which includes a variety of operative approaches, has a reported mortality rate between 20% and 78% [3][4][5][6]. The different operative choices including local repair of the duodenum, graft explantation alone, in situ replacement with autologous vein, allograft or prosthetic material and extraanatomic revascularization and graft excision.…”

Section: Introductionmentioning

confidence: 99%

Late outcome following open surgical management of secondary aortoenteric fistula

Bíró

Szabó

Fehérvári

et al. 2011

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Secondary fistulae develop after aortic intervention and typically involve the proximal suture line 1 and/or prosthetic graft material. Secondary AEF are more common, with a reported incidence of between 0.36% 2 and 4% 3 of patients who have undergone open aortic surgery. In 1999 the first case of an aortoduodenal fistula (ADF) following an endoluminal aortic graft repair was reported.…”

Section: Introductionmentioning

confidence: 99%