title: Albumin-impregnated prosthetic graft for infrarenal aortic replacement: effects on the incidence and volume of perioperative blood transfusion.
abstract: We retrospectively reviewed 290 cases in which an albumin-impregnated polyester prosthetic graft was used for surgical management of aortic bifurcation disease between November 1987 and December 1990. The purpose of this review was to determine the incidence and volume of blood transfusion and to evaluate the rate of patency and the incidence of infection achieved using this type of prosthesis. The indication for surgery was abdominal aortic aneurysm (AAA) in 218 cases (190 elective procedures and 28 emergency procedures) and occlusive disease of the aortic bifurcation (ODAB) in 72 cases. Mean follow-up was 25.5 +/- 13.4 months (range: 1 and 50 months). The incidence of blood transfusion for elective AAA and ODAB surgery was 30.2% and 32.3% intraoperatively, 21.3% and 12.9% postoperatively, and 40.4% and 42.6% overall. The mean number of red cell packs transfused for elective AAA and ODAB surgery was respectively 1 and 0.8 intraoperatively, 0.4 and 0.6 postoperatively, and 1.4 and 1 overall. No immediate or late graft infection prosthesis was observed in any patient in this series. Primary and secondary patency was 95.5% and 97.5% at 6 months with no graft thrombosis during further follow-up. The fact that use of an impregnated graft in management of aortic bifurcation disease was accompanied by a high incidence and volume of blood transfusion suggests that these grafts do not reduce perioperative blood loss. Use of an impregnated prosthesis had no effect on the rate of patency and the incidence infection.
authors.affiliation: Service de Chirurgie Cardio-Vasculaire, Hospices Civils de Strasbourg, France.
authors.forename: N
authors.initials: N
authors.lastname: Chakfé
authors.forename: M
authors.initials: M
authors.lastname: Beaufigeau
authors.forename: P
authors.initials: P
authors.lastname: Nicolini
authors.forename: E
authors.initials: E
authors.lastname: Epailly
authors.forename: F
authors.initials: F
authors.lastname: Levy
authors.forename: J C
authors.initials: JC
authors.lastname: Thiranos
authors.forename: H
authors.initials: H
authors.lastname: Petit
authors.forename: R
authors.initials: R
authors.lastname: Kieny
authors.forename: J G
authors.initials: JG
authors.lastname: Kretz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000627:therapeutic use*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D001803:Blood Transfusion; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012189:Retrospective Studies; D014654:Vascular Patency
chemical_list: D000418:Albumins