Self-Made Pericardial Tube Graft: A New Surgical Concept for Treatment of Graft Infections After Thoracic and Abdominal Aortic Procedures

Czerny, Martin; Allmen, Regula S. von; Opfermann, Philipp; Sodeck, Gottfried; Dick, Florian; Stellmes, Arno; Makaloski, Vladimir; Bühlmann, Roman; Derungs, U.; Widmer, Matthias; Carrel, Thierry; Schmidli, Jürg

doi:10.1016/j.athoracsur.2011.06.073

Cited by 109 publications

(76 citation statements)

References 14 publications

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“…Made of bovine, porcine, or equine pericardium, they are easy to handle, readily available, and additionally are resistant to several endospores, microorganisms, and viruses, because of glutaraldehyde solution 29. Earlier reports on self‐made xenopericardial tubes have been encouraging with no graft‐related late mortality or reinfections 23, 24, 30. The present study yielded correlating results, but the considerably small number of patients in all of them calls for further investigations.…”

Section: Discussionsupporting

confidence: 72%

“…The infection resistance and long‐term outcome of biological grafts in treatment of mycotic aneurysms has been reported earlier in small case series or mixed with data on aortic graft infection 20, 22, 23, 24. Patients with aortic graft infection are challenging; in addition to highly prevalent cardiovascular risk factors, operating in scar tissue complicates the treatment even further.…”

Section: Discussionmentioning

confidence: 99%

“…Preparation of the pericardial tube graft was performed by tailoring a large bovine pericardial patch according to the desired size for aortic reconstruction. Then it was sewn to construct a tube using a polypropylene 4–0 suture 23. Cryopreserved arterial allografts were commercial, thawed and handled as instructed by the providing cryobank.…”

Section: Methodsmentioning

confidence: 99%

“…Autologous femoral veins, allografts, and recently added self‐made xenopericardial tubes are the most frequently used biological materials in aorto‐iliac position. They have been applied successfully as a reconstruction material in case of aortic graft infection; however, their performance in treatment of MAAA lacks evidence 19, 20, 21, 22, 23…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Heinola

Sörelius

Wyss

et al. 2018

JAHA

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BackgroundThe treatment of mycotic abdominal aortic aneurysm requires surgery and antimicrobial therapy. Since prosthetic reconstructions carry a considerable risk of reinfection, biological grafts are noteworthy alternatives. The current study evaluated the durability, infection resistance, and midterm outcome of biological grafts in treatment of mycotic abdominal aortic aneurysm.Methods and ResultsAll patients treated with biological graft in 6 countries between 2006 and 2016 were included. Primary outcome measures were 30‐ and 90‐day survival, treatment‐related mortality, and reinfection rate. Secondary outcome measures were overall mortality and graft patency. Fifty‐six patients (46 males) with median age of 69 years (range 35–85) were included. Sixteen patients were immunocompromised (29%), 24 (43%) had concomitant infection, and 12 (21%) presented with rupture. Bacterial culture was isolated from 43 (77%). In‐situ aortic reconstruction was performed using autologous femoral veins in 30 patients (54%), xenopericardial tube‐grafts in 12 (21%), cryopreserved arterial/venous allografts in 9 (16%), and fresh arterial allografts in 5 (9%) patients. During a median follow‐up of 26 months (range 3 weeks–172 months) there were no reinfections and only 3 patients (5%) required assistance with graft patency. Thirty‐day survival was 95% (n=53) and 90‐day survival was 91% (n=51). Treatment‐related mortality was 9% (n=5). Kaplan–Meier estimation of survival at 1 year was 83% (95% confidence interval, 73%–94%) and at 5 years was 71% (52%–89%).ConclusionsMycotic abdominal aortic aneurysm repair with biological grafts is a durable option for patients fit for surgery presenting an excellent infection resistance and good overall survival.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Heinola

Sörelius

Wyss

et al. 2018

JAHA

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“…However, the accompanying esophageal lesion is limiting the long-term prognosis by recurrent sepsis and therefore, TEVAR and esophageal stenting should be considered a bridging procedure to open surgery in those patients. However, it must be subjected to further evaluation, if an aortic conversion operation (e.g., endograft replacement by homograft, 1 or pericardium 22 ) indeed is necessary, or if the endograft can remain in situ and only the esophageal lesion is targeted.…”

Section: Discussionmentioning

confidence: 99%

Strategies for Endovascular Aortic Repair in Aortobronchial and Aortoesophageal Fistulas

Dorweiler

Weigang

Duenschede

et al. 2013

Thorac cardiovasc Surg

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Objective To report our experience of thoracic endovascular aortic repair (TEVAR) for acute bleeding originating from the thoracic aorta in patients with aortobronchial fistula (ABF) or aortoesophageal fistula (AEF). Patients and Methods A total of nine patients (three woman) were treated from September 1995 to March 2012 by TEVAR for ABF (n ¼ 5) and AEF (n ¼ 4). The implants (N ¼ 14) were introduced with fluoroscopic guidance via the aorta (n ¼ 1), the iliac (n ¼ 2), or femoral (n ¼ 11) artery, respectively. Results All aortic lesions could be sealed successfully. Perioperative morbidity was 0% in the ABF group and 50% (2 of 4) in the AEF group and no procedure-related morbidity was noted except one patient who received aortofemoral reconstruction because of iliac occlusive disease. After an overall mean follow-up of 56 months, three patients of the ABF group are alive and well and two patients died of nonrelated cause. Of the AEF group, one patient is alive after 22 months, and one died from metastasized esophageal cancer after 7 months. Conclusion TEVAR is a safe and reliable procedure in the management of ABF. For AEF, TEVAR provides a successful first-line treatment to seal the fistula and control bleeding. However, prognosis is limited by the esophageal lesion and by ongoing mediastinitis/ sepsis.

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Mammalian Pericardium‐Based Bioprosthetic Materials in Xenotransplantation and Tissue Engineering

Grebenik

Gafarova

Истранов

et al. 2020

Biotechnology Journal

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Bioprosthetic materials based on mammalian pericardium tissue are the gold standard in reconstructive surgery. Their application range covers repair of rectovaginal septum defects, abdominoplastics, urethroplasty, duraplastics, maxillofacial, ophthalmic, thoracic and cardiovascular reconstruction, etc. However, a number of factors contribute to the success of their integration into the host tissue including structural organization, mechanical strength, biocompatibility, immunogenicity, surface chemistry, and biodegradability. In order to improve the material's properties, various strategies are developed, such as decellularization, crosslinking, and detoxification. In this review, the existing issues and long‐term achievements in the development of bioprosthetic materials based on the mammalian pericardium tissue, aimed at a wide‐spectrum application in reconstructive surgery are analyzed. The basic technical approaches to preparation of biocompatible forms providing continuous functioning, optimization of biomechanical and functional properties, and clinical applicability are described.

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Self-Made Pericardial Tube Graft: A New Surgical Concept for Treatment of Graft Infections After Thoracic and Abdominal Aortic Procedures

Cited by 109 publications

References 14 publications

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Strategies for Endovascular Aortic Repair in Aortobronchial and Aortoesophageal Fistulas

Mammalian Pericardium‐Based Bioprosthetic Materials in Xenotransplantation and Tissue Engineering

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