[Management of the aortic graft infection]

Prosthetic graft infection is a life-threatening complication in aortic surgery. Ectopic gas, perigraft fluid collection, and pseudoaneurysm can be detected by CT scanning. In cases of graft-enteric fistula, the prosthetic material can sometimes be observed using gastroduodenoscopy. Several methods of treatment have been attempted clinically. Removal of the infected graft and additional extra-anatomic bypass are associated with acceptable surgical outcomes, although the mortality rates are high because of persistent infection or aortic stump rupture. In-situ prosthetic graft replacement or omental transposition has also been attempted, although control of the infection has rarely been achieved. In-situ replacement with a cyropreserved aortic allograft considered to be resistant against infection has recently been performed. The immunological rejection or long-term patency rate of aortic allografts is unknown. However, this technique appears to be a useful option for the management of aortic graft infection.