Treatment of Prosthetic Graft Infection after Thoracic Aorta Replacement

Purpose: Prosthetic graft infection is a fatal complication after thoracic aorta replacement, and it is sometimes difficult to perform a prompt re-operation when the patient carries the infectious source of the graft. We evaluated the early and mid-term outcomes of aortic graft infection after thoracic aorta replacement, focusing on the timing of the surgery. Methods: This study included eight consecutive patients with thoracic graft infection from 1997 to 2011 among 513 patients of graft replacement during this period. We performed re-graft replacement in six patients. Of these six patients, emergency surgery was performed in two and scheduled surgery was performed in two. An unscheduled emergency surgery was required in two patients during the medical treatment of the infection source. Solo medical treatment was performed in two patients. Results: In-hospital mortality occurred in two of the eight patients (25%). Re-graft infection was not observed in the six patients who underwent re-graft replacement or the one patient who underwent medical treatment during the 1.5- to 14-year observation period. Conclusions: Prompt re-replacement of the infected graft should be performed even when an orthotopic infection source led to the graft infection. Medical treatment might be applicable when neither an abscess nor pseudoaneurysm is observed.