Introduction:

aortic graft infection (AGI) after aortic open repair is an unusual (0.7-3 %) and potentially lethal complication. Standard treatment has been excision of infected graft and extra anatomic bypass, although currently there are in situ repair techniques. Global perioperative mortality is 4-40 % according to the series and the repair technique.

Objectives:

to report our experience with extra anatomic revascularization and excision of infected graft in AGI.

Methodology:

retrospective study between 1977 and 2020. Were included patients with AGI treated with extra anatomic revascularization and excision of infected graft only. Demographics, morbidities, clinical presentation and microbiological agents were considered. Primary outcome was postoperative mortality. Secondary outcomes were reinterventions, postoperative complications, major amputations, bypass patency and long-term survival. Descriptive statistics were performed and dycotomical asociations were established with chi-squared test.

Results:

sixteen patients, all male. Average age 69.2 years (55-82). Average time to infection from surgery was 27.8 months (1-84). AGI was more frequent in patients with ruptured aortic aneurysm (p < 0.05). Eleven patients (68.8 %) had fever, 6 (37.5 %) consulted with abdominal or lumbar pain, 5 (31.3 %) had inflammatory changes of local skin. Twelve patients (75 %) had aortoduodenal communications. Three patients (18.8 %) had lower limb ischemia. Seven patients (43.8 %) presented postoperative complications and 2 patients expired (12.5 %). Actuarial one-year and five-year survival were 86.7 % and 64.3 %, respectively. Five-year primary and secondary patency of the axillofemoral bypass were 77.8 % and 100 %, respectively.

Conclusions:

AGI is a serious condition, which treatment carries significant morbidity and mortality. Axillofemoral bypass grafting and infected graft excision currently is a safe alternative of treatment.

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