Vogt P R, von Segesser L K, Goffin Y, Niederhäuser U, Genoni M, Künzli A, Lachat M, Turina M I
Clinic for Cardiovascular Surgery, University Hospital, Zurich, Switzerland.
Ann Thorac Surg. 1996 Sep;62(3):640-5. doi: 10.1016/s0003-4975(96)0045-4.
The surgical treatment of vascular infection is associated with a substantial early and late mortality. Cryopreserved homografts were evaluated for in situ reconstruction in aortic infections.
Between January 1991 and July 1995, homografts were used in 19 patients (mean age, 61 +/- 13 years; range, 40-85 years) with mycotic aneurysms (9/19; 47%) or infected grafts (10/19; 53%) in the thoracic (7/19; 37%) or abdominal (12/19; 63%) aorta. Sepsis was present preoperatively in 14 of 19 (74%) patients, and 18 of 19 (95%) had received antibiotic treatment for 6.4 +/- 6 months (range, 1-36 months). Up to ten previous vascular procedures had been done in 11 of 19 patients (58%).
There was one (5.2%) early and two (11%) late deaths, with one (5.5%) of the late deaths being homograft related. The mean hospital stay was 27 +/- 26 days (range, 7-84 days). Antibiotics were given postoperatively for 30 +/- 12 days (range, 4-84 days). During the follow-up period of 18.6 +/- 13 months (range, 7-60 months), there were no instances of reinfection, suture line rupture, homograft stenosis, or anastomotic aneurysms.
Cryopreserved arterial homografts allow safe in situ reconstruction, decrease early and midterm mortality, and reduce antibiotic requirements. Early and midterm reoperations are unnecessary.
血管感染的外科治疗与较高的早期和晚期死亡率相关。对冷冻保存的同种移植物进行评估，以用于主动脉感染的原位重建。
1991年1月至1995年7月期间，19例患者（平均年龄61±13岁；范围40 - 85岁）使用了同种移植物，这些患者患有真菌性动脉瘤（9/19；47%）或移植血管感染（10/19；53%），病变位于胸主动脉（7/19；37%）或腹主动脉（12/19；63%）。19例患者中有14例（74%）术前存在败血症，19例中有18例（95%）接受了6.4±6个月（范围1 - 36个月）的抗生素治疗。19例患者中有11例（58%）此前接受过多达十次血管手术。
有1例（5.2%）早期死亡和2例（11%）晚期死亡，其中1例（5.5%）晚期死亡与同种移植物相关。平均住院时间为27±26天（范围7 - 84天）。术后给予抗生素30±12天（范围4 - 84天）。在18.6±13个月（范围7 - 60个月）的随访期内，未发生再感染、缝线处破裂、同种移植物狭窄或吻合口动脉瘤。
冷冻保存的动脉同种移植物可实现安全的原位重建，降低早期和中期死亡率，并减少抗生素需求。无需进行早期和中期再次手术。
