title: Successful surgical in situ treatment of prosthetic graft infection by staged procedure after Bentall operation and total aortic arch replacement.
abstract: We report a case of a 29-year-old Marfan patient who developed prosthetic graft infection 10 months after Bentall operation and successive replacement of the remaining ascending aorta and the entire aortic arch for acute aortic dissection. Instead of an aggressive high-risk aortic redo procedure with removal and replacement of the infected prosthetic graft we elected a staged graft-sparing surgical approach. After 18 months of close follow-up the patient is in good condition and free from infectious sequela. This case and our review of the literature suggest that open extensive disinfection followed by tissue flap coverage is highly effective in controlling thoracic aortic prosthetic graft infection and may be considered as first-line treatment in such high-risk aortic arch redo patients.
authors.affiliation: Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Paschalis
authors.initials: P
authors.lastname: Tossios
authors.affiliation: Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Avgerinos
authors.initials: A
authors.lastname: Karatzopoulos
authors.affiliation: Department of Thoracic and Cardiovascular Surgery, West German Heart Center, University Hospital Essen, Essen, Germany.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsagakis
authors.affiliation: 3rd Surgical Department, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Sapalidis
authors.affiliation: Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Konstantina
authors.initials: K
authors.lastname: Triantafillopoulou
authors.affiliation: Department of Radiology, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Kalogera
authors.affiliation: Department of Cardiothoracic Surgery, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Georgios T
authors.initials: GT
authors.lastname: Karapanagiotidis
authors.affiliation: Department of Anesthesia and Intensive Care, Aristotle University Medical School, AHEPA University Hospital, Thessaloniki, Greece.
authors.forename: Vasilios
authors.initials: V
authors.lastname: Grosomanidis
keywords: Aortic arch; Ascending aorta; In situ preservation; Omentum transposition; Prosthetic graft infection
references.citation: Eur J Vasc Endovasc Surg. 2012 Feb;43(2):174-81
references.pmid: 22155121
references.citation: Ann Thorac Surg. 1999 Jun;67(6):1994-6; discussion 1997-8
references.pmid: 10391356
references.citation: J Thorac Cardiovasc Surg. 2007 Oct;134(4):839-43
references.pmid: 17903492
references.citation: Ann Thorac Surg. 2011 Nov;92(5):1657-62
references.pmid: 21945229
references.citation: Ann Thorac Surg. 1999 Jun;67(6):1990-3; discussion 1997-8
references.pmid: 10391355
references.citation: J Thorac Cardiovasc Surg. 2007 Oct;134(4):1051-2
references.pmid: 17903532
references.citation: Ann Thorac Surg. 1984 Jan;37(1):72-7
references.pmid: 6691740
references.citation: Ann Thorac Surg. 1990 Dec;50(6):868-81
references.pmid: 2241378
references.citation: Eur J Cardiothorac Surg. 2013 Jun;43(6):1170-5
references.pmid: 23137558