Autogenous paneled femoral vein grafts for mycotic thoracic aortic aneurysms
Ningzhi Gu1, Eimaan Shergill2, D Kirk Lawlor1
1Division of Vascular Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
Objective:
Mycotic thoracic aortic aneurysms (MTAAs) are rare. The most common management has been aortic resection, wide debridement, and in-line reconstruction using prosthetic grafts. We have used autogenous femoral vein (FV) for the repair of all MTAA in our institution since 2017. This is the initial description of this technique, and the first comparative study of autogenous vein compared with prosthetic for MTAAs.
Methods:
This is a single-center retrospective cohort study of all patients with MTAA who underwent operative repair. Patients were assigned to the FV or prosthetic grafts cohorts. Perioperative and long-term outcomes were collected. Univariate logistic regression models were fitted to quantify the strength of differences between the cohorts.
Results:
Nineteen patients were included. The first 9 consecutive patients had prosthetic grafts, whereas the 10 subsequent patients were treated with FV grafts. Patients in the FV cohort were more likely to have positive intraoperative cultures (90% vs 33.3%; P = .02), receive intraoperative transfusions (10 vs 8 units; P = .08), and have a longer operation (629 vs 500 minutes; P = .07). There was a trend toward improved in-hospital (0 vs 33%; P = .09) and long-term mortality (10% vs 55.6%; P = .57) in the FV cohort. Patients in the FV cohort were more likely to be discharged home (90% vs 44.4%; P = .05).
Conclusions:
Paneled autogenous FV repair is a durable and safe treatment for patients with MTAA. There were no in-hospital deaths in our series and there have been no long-term complications related to the vein graft repair.
Insights
Autogenous femoral vein (FV) repair is a safe and durable treatment for mycotic thoracic aortic aneurysms (MTAAs). This study found FV grafts were associated with better outcomes and lower mortality compared to prosthetic grafts.
Area of Science:
- Cardiovascular Surgery
- Vascular Surgery
- Aortic Aneurysm Research
Background:
- Mycotic thoracic aortic aneurysms (MTAAs) are rare but serious conditions.
- Traditional management involves aortic resection and prosthetic graft reconstruction.
- Autogenous femoral vein (FV) has emerged as an alternative repair material.
Purpose of the Study:
- To describe the technique of autogenous FV repair for MTAA.
- To compare the outcomes of FV repair versus prosthetic grafts for MTAA.
- To evaluate the safety and durability of FV grafts in MTAA management.
Main Methods:
- Single-center retrospective cohort study.
- Patients with MTAA were divided into FV graft and prosthetic graft cohorts.
- Perioperative and long-term outcomes were analyzed using logistic regression.
Main Results:
- The FV cohort had higher rates of positive intraoperative cultures (90% vs 33.3%) and longer operative times.
- A trend towards improved in-hospital (0% vs 33%) and long-term mortality (10% vs 55.6%) was observed in the FV cohort.
- Patients receiving FV grafts were more likely to be discharged home (90% vs 44.4%).
Conclusions:
- Autogenous FV repair is a safe and durable option for MTAA.
- No in-hospital deaths occurred in the FV cohort.
- No long-term complications related to FV graft repair were reported.
More Related Videos
09:09A Modified Heterotopic Swine Hind Limb Transplant Model for Translational Vascularized Composite Allotransplantation VCA Research
Published on: October 14, 2013
09:04Synergizing Antegrade Endoscopic with Bridging Vein Harvesting for Improvement of Great Saphenous Vein Graft Quality from the Lower Leg
Published on: November 19, 2019
