Improving survival and limb salvage in patients with aortic graft infection.
A 15-year experience with 38 aortic graft infections, including 15 patients with graft enteric fistulas, is reviewed in order to analyze modern-day surgical results utilizing extra-anatomic bypass and aortic graft excision. Perioperative mortality was 14% during the most recent 7-year interval, which was a notable improvement compared with the earlier time interval (p = 0.06). Extended follow-up of the perioperative survivors demonstrated a 77% cumulative 5-year survival and a 76% cumulative 5-year limb salvage rate. Subsequent axillofemoral graft infection occurred in 22% of survivors and resulted in a significantly higher amputation rate compared with those patients with no axillofemoral graft infection (p less than 0.001). The results suggest good perioperative and long-term survival in patients with aortic graft infection, with excellent limb salvage if subsequent axillofemoral graft infection can be avoided.
Yeager
R A
RA
Department of Surgery, Oregon Health Sciences University, Portland.
Moneta
G L
GL
Taylor
L M
LM
Harris
E J
EJ
McConnell
D B
DB
Porter
J M
JM
D000368:Aged; D000671:Amputation, Surgical; D001012:Aorta, Abdominal / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007239:Infections / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D007866:Leg / Q000601:surgery; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012086:Reoperation