Self Made Xeno-pericardial Aortic Tubes to Treat Native and Aortic Graft Infections

Abstract

Surgical treatment of native and aortic graft or endograft infection remains high risk. Self made bovine pericardial tube grafts for in situ reconstruction are a promising option offering many advantages. Despite high early mortality rates, early radiological and mid-term clinical results are good. Definitive eradication of the infection seems feasible after in situ insertion of xeno-pericardial material for aortic repair.

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

“…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.…”

“…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.…”

Editor's Choice – Current Options and Recommendations for the Treatment of Thoracic Aortic Pathologies Involving the Aortic Arch: An Expert Consensus Document of the European Association for Cardio-Thoracic Surgery (EACTS) & the European Society for Vascular Surgery (ESVS)

“…Xenopericardial material (self-made tube grafts) due to permanent off-the-shelf availability, ease of handling and good clinical results is favoured. 236,237 In addition, antibiotic therapy may be withdrawn in many cases during follow-up, which is the exception in patients after alloplastic replacement.…”

Management of Aortic Infections: Role of Open Surgery and the Value of Multidisciplinary Team Approach

“…Once the main device and other infected prosthetic materials have been removed, the arterial circulation must be reconstructed, and in the case of infection, this should not involve placing new prosthetic material in the infected field. Previously this has been by axillobifemoral bypass, but attention has moved towards in situ reconstruction using biological materials [18][19][20][21][22][23][24][25].…”