MANAGEMENT OF ABDOMINAL AORTIC GRAFT COMPLICATIONS

Objective This study reviews the outcome of 61 patients who underwent 66 reoperations for complications of aortic grafts. There were 25 pati ents with false aneurysm of an aortic anastomosis and 41 patients with graft infection, 17 of whom had involvement of the gastrointestinal t ract. Summary Background Data Significant late complications of aortic grafting occurred in 2% of patients. The mode of clinical presentatio n, the clinical characteristics, and outcome in these patients has not been emphasized. Methods This study reviews our experience with patie nts with complications of aortic grafts requiring graft excision or re placement with a view towards identifying prominent and important clin ical characteristics and predictors of successful treatment. Conclusio ns Patients with involvement of the gastrointestinal tract have higher mortality and morbidity than patients with simple aortic graft infect ion or those who require aortic graft replacement for pseudoaneurysm f ormation at the aortic anastomosis. These patients require longer hosp italization, more blood transfusion, and have higher operative and lon g-term mortality. Revascularization of the lower extremities should be attempted and has a high rate of limb salvage although revision or th rombectomy may be required. The authors recommend complete graft excis ion and extra-anatomic bypass for patients with aortic graft infection s.