title: Novel extra-anatomic intra-abdominal reconstruction for treatment of paravisceral aortic infection.
abstract: Adequate treatment of native or prosthetic aortic infection requires extensive surgical debridement and establishing flow to the extremities using extra-anatomic or in situ reconstruction, each with its inherent limitations. Infection of the paravisceral aortic segment precludes an axillofemoral bypass as the sole treatment because of inability to provide visceral perfusion. In situ autograft or allograft reconstructions could be limited by conduit availability or significantly prolonged operative time, or both. Placement of an antibiotic-soaked prosthetic in a field with gross purulence carries a high risk of reinfection. We describe a technique for extra-anatomic, intra-abdominal reconstruction using an antibiotic-soaked prosthetic graft to avoid the infected paravisceral aortic bed and achieve antegrade lower extremity and visceral vessel perfusion.
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Nitin
authors.initials: N
authors.lastname: Garg
authors.forename: Manju
authors.initials: M
authors.lastname: Kalra
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000785:Aneurysm, Infected / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery; D001027:Aortography / Q000379:methods; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation; D020099:Coated Materials, Biocompatible; D003646:Debridement; D020878:Device Removal; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000295:instrumentation*; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D020099:Coated Materials, Biocompatible