title: Bovine pericardial patch repair in infected fields.
abstract: OBJECTIVE
  Bovine pericardial patches (BPP) are frequently used for arterial reconstruction, but little data exist regarding their ability to resist infection. We hypothesize that BPP would provide a reasonable alternative to autologous vein patches in infected fields.
  
  
  METHODS
  We used BPP to repair 51 arteriotomies (25 brachial, 23 femoral, three popliteal) in 48 consecutive patients (mean age, 68 years; 65% men, 75% diabetic, 67% dialysis dependent) undergoing removal of infected (33 gram-positive, three gram-negative, eight mixed flora, and four culture-negative) polytetrafluoroethylene grafts (35 arteriovenous grafts, nine femoral-distal bypasses, and four femoral patch angioplasties) between January 2007 and January 2011. Patient records were retrospectively reviewed and outcomes, including death, rupture, secondary reconstruction, and infection, were recorded.
  
  
  RESULTS
  Over a mean follow-up of 2.1 years (range, 3-48 months), 50 of 51 patches remained in place without evidence of recurrent infection, rupture, or revision. One patient had acute rupture of a popliteal arteriotomy 1 week postrepair and had subsequent ligation and above-knee amputation. Eight of the 48 patients died from unrelated causes during follow-up (three withdrew from dialysis, three myocardial infarction, and two unknown).
  
  
  CONCLUSIONS
  BPP provide a durable alternative to saphenous vein for arterial reconstruction following removal of infected arterial grafts.
authors.affiliation: Minneapolis Vascular Physicians, Plymouth, MN 55456, USA. wmcmillan@mplsrad.com
authors.forename: William D
authors.initials: WD
authors.lastname: McMillan
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Leville
authors.forename: Chantel N
authors.initials: CN
authors.lastname: Hile
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D002417:Cattle; D003131:Combined Modality Therapy; D020878:Device Removal; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D010496:Pericardium / Q000637:transplantation*; D016459:Prosthesis-Related Infections / Q000188:drug therapy / Q000382:microbiology / Q000401:mortality / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents