Conservative treatment of major aortic graft infection

Major infections of Dacron aortic grafts involving the proximal anastomosis or the whole graft are rare but lethal. Traditional surgical treatment involves radical excision of the graft and extra-anatomic revascularisation of the lower limbs, and carries a forbidding mortality and complication rate. This paper describes an alternative conservative approach used on four patients, three of whom appear to have been successfully treated by continuous antibiotic irrigation of the prosthesis without removal of the graft, whilst the fourth died 42 months later of recurrent graft infection. This is the first time that prolonged survival has been reported following conservative treatment of major graft infection. The authors believe this method may offer substantial advantages over the traditional surgical treatment for this dreaded complication of aortic surgery.