The use of an aortic allograft in infection of an aortic prosthesis in a patient with a multi-storey lesion of the arterial bed of the lower extremities

Abstract

The article presents a clinical case of treatment of patient K, 61 years old, with previously performed aorto-femoral bifurcation bypass surgery for critical lower limb ischemia. 6 months after the initial surgery, the patient developed thrombosis of the right arm of the prosthesis. After another 3 months, a persistent subfebrile body temperature appeared, multiple fistula passages formed with the release of pus in the areas of postoperative scars on the hips. Infection of a synthetic prosthesis was diagnosed. A decision was made to perform repeated surgical intervention in the volume of abdominal aortic reprosthetics with a cadaveric allograft. The surgery was performed at the clinic of the Faculty of Surgery of SamSMU: removal of the bifurcation synthetic prosthesis; rehabilitation of the prosthesis bed; reprosthetics of the aorta with vascular aortic allograft; endarterectomy from the deep artery of the thigh on both sides; bifurcation aorto-femoral reprosthetics; femoral-popliteal bypass with allograft on the right. The postoperative period was uneventful. Healing of wounds on the hips by secondary tension due to marginal skin necrosis. Critical limb ischemia was stopped. The patient was discharged on the 20th day in a satisfactory condition.CONCLUSION. The use of allografts makes it possible to perform reprosthetics of the abdominal aorta in case of infection of synthetic prosthesis and simultaneous reconstruction of the femoral-popliteal segment.