EXPERIENCE WITH CRYOPRESERVED ARTERIAL ALLOGRAFTS IN THE TREATMENT OFPROSTHETIC GRAFT INFECTIONS

The authors present a retrospective study on 30 patients with prosthet ic graft infection. Included are 25 patients with aortic graft infecti on, three with infection of a femorodistal bypass and two with infecte d axillofemoral grafts. There were 23 isolated primary prosthetic graf t infections and seven aorto-enteric fistulas, Treatment consisted of graft excision and replacement with cryopreserved arterial homografts, harvested from brain-death multi-organ donors. The in situ technique was used in 27 cases. Eight patients died postoperatively and two deat hs were from allograft related complications. The operative mortality rate was 11% for isolated aortic graft sepsis and the early limb salva ge rate was 100%, Persistent or recurrent infection was noted in two c ases. The mean follow-up of the series was 24.5 months and occlusive c omplications occurred in five patients (23%), which resulted in two ma jor amputations. Serial CT scans showed abnormalities in six of the 22 survivors, all of them related to the aortic segment of the allograft , It is concluded that in situ reconstruction with cryopreserved arter ial allografts represents an acceptable alternative, especially in the treatment of isolated aortic graft sepsis, Continued follow-up toward s late deterioration and/or occlusive complications remains mandatory. (C) 1998 The International Society for Cardiovascular Surgery. Publis hed by Elsevier Science Ltd. All rights reserved.