Cryopreserved arterial allografts in the treatment of major vascular infection: a comparison with conventional surgical techniques

Details

Serval ID
serval:BIB_1DAA46B891C3
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Cryopreserved arterial allografts in the treatment of major vascular infection: a comparison with conventional surgical techniques
Journal
Journal of Thoracic and Cardiovascular Surgery
Author(s)
Vogt  P. R., Brunner-La Rocca  H. P., Carrel  T., von Segesser  L. K., Ruef  C., Debatin  J., Seifert  B., Kiowski  W., Turina  M. I.
ISSN
0022-5223
Publication state
Published
Issued date
12/1998
Peer-reviewed
Oui
Volume
116
Number
6
Pages
965-72
Notes
Comparative Study
Journal Article --- Old month value: Dec
Abstract
OBJECTIVE: Recent findings with cryopreserved heart valve allografts in the treatment of infectious endocarditis suggest that the use of cryopreserved arterial allografts may improve the outcome in patients with vascular infections. METHODS: Seventy-two patients with mycotic aneurysms (n = 29) or infected vascular prostheses (n = 43) of the thoracic (n = 26) or abdominal aorta (n = 46) were treated with in situ repair and extra-anatomic reconstruction using prosthetic material (n = 38) or implantation of a cryopreserved arterial allograft (n = 34). Disease-related survival and survival free of reoperation were assessed. Morbidity, cumulative lengths of intensive care, hospitalization, antibiotic treatment, and costs were calculated per year of follow-up. RESULTS: The use of cryopreserved arterial allografts was superior to conventional surgery in terms of disease-related survival (P =.008), disease-related survival free of reoperation (P =.0001), duration of intensive care per year of follow-up (median 1 vs 11 days; range 1 to 42 vs 2 to 120 days; P =.001), hospitalization (14 vs 30 days; range 7 to 150 vs 15 to 240 days; P =.002), duration of postoperative antibiotic therapy (21 vs 40 days; range 21 to 90 vs 60 to 365 days; P =.002), incidence of complications (24% vs 63%; P =.005), and elimination of infection (91% vs 53%; P =.001). In addition, costs were 40% lower in the group treated by allografts (P =.005). CONCLUSIONS: The use of cryopreserved arterial allografts is a more effective treatment for mycotic aneurysms and infected vascular prostheses than conventional surgical techniques.
Keywords
Adult Aged Aged, 80 and over Aneurysm, Infected/etiology/mortality/*surgery Aortic Aneurysm, Abdominal/etiology/surgery Aortic Aneurysm, Thoracic/etiology/surgery Arteries/cytology/*transplantation Blood Vessel Prosthesis/*adverse effects Cost-Benefit Analysis *Cryopreservation Female Follow-Up Studies Humans Male Middle Aged Prosthesis-Related Infections/etiology/mortality/*surgery Retrospective Studies Transplantation, Homologous/economics
Pubmed
Web of science
Open Access
Yes
Create date
14/02/2008 14:19
Last modification date
20/08/2019 12:53
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