[Vascular homografts: strategies and operative techniques]

The author propose a detailed analysis of all the critical aspects that must be kept in mind when, in case of graft infection, the choice is to utilize an arterial homograft. Patient suitable to this procedure, as well as clinical and diagnostical relevance of graft infection and characteristics of the donor's material are widely examined. The surgical techniques about a) patient preparation and management, b) infected graft removal and c) homograft implant are specifically discussed and analyzed. Post-operative care and follow-up are discussed and planned. This experience is the result of a aspecific trial begun in Busto Arsizio Vascular Surgery Dept.-Busto Arsizio Hospital-Varese-Italy, where, starting from March 1994 until September 1996 21 homograft have been implanted in 20 patients (19 in aortic district). Population characteristics and results are critically examined, with particular attention to the death rate of 15%.