Successful Treatment of an Infected Zenith Fenestrated Endograft Without Explantation

Current surgical dogma for infected aortic endografts consists of complete explantation concurrent with revascularization via extra-anatomic bypass or in situ infection-resistant conduit. However, this treatment paradigm is associated with high rates of postoperative mortality and major morbidity. Therefore, patients with prohibitive operative risk are often not offered surgical intervention. In the following manuscript, we report the successful treatment of an 85-year-old gentleman with a fenestrated aortic endograft (Cook Medical, Bloomington, Indiana) infected secondary to the formation of an aortoenteric fistula with primary bowel repair, washout, and lifelong antibiotics and followed for nearly 2 years after intervention. Therefore, this nonexplantation approach can be considered for patients who may otherwise have no surgical recourse.