title: Cryopreserved aortic homograft for in situ replacement of infected thoracic stent graft associated with distal aortic arch rupture and hematemesis.
abstract: Endograft infections present a potentially lethal complication of thoracic endovascular aortic repair (TEVAR). We report a case of a young male patient who was referred to our institution because of a stent graft infection that occurred 10 months after TEVAR. Contained distal aortic arch rupture and hematemesis were associated with the endograft infection. Emergent open surgical repair was undertaken with deep hypothermic circulatory arrest. After the removal of the infected endograft, the distal aortic arch and proximal descending thoracic aorta were replaced with a cryopreserved aortic homograft. Fifteen-month follow-up was uneventful. We discuss techniques and materials for replacement of the infected endograft. The article provides an outline of the potential benefit of cryopreserved aortic homografts within the setting of a complex thoracic aortic infection.
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Mladen
authors.initials: M
authors.lastname: Petrunić
authors.affiliation: Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Bojan
authors.initials: B
authors.lastname: Biočina
authors.affiliation: Department of Anesthesiology, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Uzun
authors.affiliation: Department of Surgery, Division of Vascular Surgery, University Hospital Center Zagreb, Zagreb, Croatia. Electronic address: mestrovic.tomislav@gmail.com.
authors.forename: Tomislav
authors.initials: T
authors.lastname: Meštrović
authors.affiliation: Department of Cardiac Surgery, University Hospital Center Zagreb, Zagreb, Croatia.
authors.forename: Ivica
authors.initials: I
authors.lastname: Šafradin
mesh_terms: D064591:Allografts; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D001013:Aorta, Thoracic / Q000601:surgery*; D017545:Aortic Aneurysm, Thoracic / Q000601:surgery; D001019:Aortic Rupture / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015925:Cryopreservation; D057510:Endovascular Procedures / Q000379:methods; D006396:Hematemesis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D016459:Prosthesis-Related Infections / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D055815:Young Adult