PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION.
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48750/acv.161 |
Resumo: | Introduction and Purpose: Aortic prosthetic graft infection is a rare but potentially fatal complication. Treatment require the complete excision of the prosthetic material, debridement of the surrounding tissues, broad-spectrum antibiotics, and limb revascularization which can be done through in situ reconstruction or by extra-anatomic solutions. The authors present a case of an in situ reconstruction with bovine pericardium graft. Methods and Results: We report a case of a patient, previously submitted to a aortic-bifemoral bypass with Dacron prosthesis complicated of infection six years after and treated with complete excision and in-situ reconstruction with bifurcated Dacron silvergrat and antibiotics for life. One year after the patient develop bilateral pulsatile groin mass with inflammatory signs and fever. The computed tomography showed signs of prosthetic infection, aposition of D3 duodenal portion with the underlying prosthesis. The patient is submitted a total graft excision, fistulectomy with duodenojejunostomy and an in situ aortic reconstruction with a Y graft tailored from a self-made tube graft from bovine pericardium and endarterectomized superficial femoral arteries. The patient underwent a 45 days antibiotic regimen and it was discharged with an overall good condition. Discussion and Conclusion: Patients with infectious aortic disease present in a frail state and with high risk of mortality and morbidity. Because of their off-the-shelf availability, handling properties, and freedom from reinfection and durability, self-made bovine pericardial grafts are an useful option in urgent reconstruction of vascular infections. |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION.CONSTRUÇÃO DE NEO-AORTA PARA RESOLUÇÃO DE CATÁSTROFE VASCULAR — SOLUÇÃO INOVADORA PARA CASOS DE INFEÇÃO PROTÉSICAAortic prosthetic infectionIn-situ reconstructionBovine pericardiumInfeção protésicaReconstrução in situPericárdio bovinoIntroduction and Purpose: Aortic prosthetic graft infection is a rare but potentially fatal complication. Treatment require the complete excision of the prosthetic material, debridement of the surrounding tissues, broad-spectrum antibiotics, and limb revascularization which can be done through in situ reconstruction or by extra-anatomic solutions. The authors present a case of an in situ reconstruction with bovine pericardium graft. Methods and Results: We report a case of a patient, previously submitted to a aortic-bifemoral bypass with Dacron prosthesis complicated of infection six years after and treated with complete excision and in-situ reconstruction with bifurcated Dacron silvergrat and antibiotics for life. One year after the patient develop bilateral pulsatile groin mass with inflammatory signs and fever. The computed tomography showed signs of prosthetic infection, aposition of D3 duodenal portion with the underlying prosthesis. The patient is submitted a total graft excision, fistulectomy with duodenojejunostomy and an in situ aortic reconstruction with a Y graft tailored from a self-made tube graft from bovine pericardium and endarterectomized superficial femoral arteries. The patient underwent a 45 days antibiotic regimen and it was discharged with an overall good condition. Discussion and Conclusion: Patients with infectious aortic disease present in a frail state and with high risk of mortality and morbidity. Because of their off-the-shelf availability, handling properties, and freedom from reinfection and durability, self-made bovine pericardial grafts are an useful option in urgent reconstruction of vascular infections.Introdução e Objetivo: A infeção protésica aórtica é uma complicação rara mas potencialmente fatal. O seu tratamento requer a excisão completa do material protésico, desbridamento dos tecidos infectados circundantes, antibiótico de largo espectro e revascularização que pode ser realizada através de uma reconstrução in situ ou bypass extra-anatómico. Os autores apresentam um caso de reconstrução in situ com enxerto de pericárdio bovino. Métodos e Resultados: Reportamos o caso de um doente previamente submetido a um bypass aorto-bifemoral com prótese de Dacron complicada de infeção aos 6 anos e foi submetido a excisão completa da prótese vascular e recontrução in situ com prótese bifurcada de prata. Após 1 ano, o doente iniciou quadro clínico de febre e tumefação inguinal pulsátil bilateral com sinais inflamatórios. A tomografia computorizada mostrou sinais de infeção protésica, completa aposição de ansa duodenal D3 à prótese de Dacron. Foi operado com excisão total da prótese, exclusão da fistula através de uma doudenojejunostomia e reconstrução in situ com enxerto biológico tubular em Y com tubo de pericárdio bovino e artérias femorais superficiais endartrectomizadas ex vivo. Teve alta após 45 dias de antibiótico endovenoso e com bom estado geral. Discussão e Conclusão: Os doentes com infeção aórtica apresentam um estado frágil e com alto risco de mortalidade e morbilidade. Devido ás suas propriedades de disponibilidade imediata, manuseio fácil, baixo risco de reinfeção e durabilidade, os enxertos de pericárdio bovino são uma opção útil na reconstrução urgente de infeções vasculares. Sociedade Portuguesa de Angiologia e Cirurgia Vascular2019-05-15T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.48750/acv.161oai:ojs.acvjournal.com:article/161Angiologia e Cirurgia Vascular; Vol. 14 No. 4 (2018): December; 347-350Angiologia e Cirurgia Vascular; Vol. 14 N.º 4 (2018): Dezembro; 347-3502183-00961646-706Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://acvjournal.com/index.php/acv/article/view/161https://doi.org/10.48750/acv.161http://acvjournal.com/index.php/acv/article/view/161/122Copyright (c) 2019 Angiologia e Cirurgia Vascularinfo:eu-repo/semantics/openAccessAfonso, AnaRodrigues, HugoMarques, GilVieira, JoãoSousa, GonçaloFerreira, Maria José2022-05-23T15:10:03Zoai:ojs.acvjournal.com:article/161Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T14:57:33.307804Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. CONSTRUÇÃO DE NEO-AORTA PARA RESOLUÇÃO DE CATÁSTROFE VASCULAR — SOLUÇÃO INOVADORA PARA CASOS DE INFEÇÃO PROTÉSICA |
title |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
spellingShingle |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. Afonso, Ana Aortic prosthetic infection In-situ reconstruction Bovine pericardium Infeção protésica Reconstrução in situ Pericárdio bovino |
title_short |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
title_full |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
title_fullStr |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
title_full_unstemmed |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
title_sort |
PERICARDIAL NEO-AORTA FOR RESOLUTION OF A VASCULAR CATASTROPHY. INNOVATIVE SOLUTION FOR AORTIC PROSTHETIC INFECTION. |
author |
Afonso, Ana |
author_facet |
Afonso, Ana Rodrigues, Hugo Marques, Gil Vieira, João Sousa, Gonçalo Ferreira, Maria José |
author_role |
author |
author2 |
Rodrigues, Hugo Marques, Gil Vieira, João Sousa, Gonçalo Ferreira, Maria José |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Afonso, Ana Rodrigues, Hugo Marques, Gil Vieira, João Sousa, Gonçalo Ferreira, Maria José |
dc.subject.por.fl_str_mv |
Aortic prosthetic infection In-situ reconstruction Bovine pericardium Infeção protésica Reconstrução in situ Pericárdio bovino |
topic |
Aortic prosthetic infection In-situ reconstruction Bovine pericardium Infeção protésica Reconstrução in situ Pericárdio bovino |
description |
Introduction and Purpose: Aortic prosthetic graft infection is a rare but potentially fatal complication. Treatment require the complete excision of the prosthetic material, debridement of the surrounding tissues, broad-spectrum antibiotics, and limb revascularization which can be done through in situ reconstruction or by extra-anatomic solutions. The authors present a case of an in situ reconstruction with bovine pericardium graft. Methods and Results: We report a case of a patient, previously submitted to a aortic-bifemoral bypass with Dacron prosthesis complicated of infection six years after and treated with complete excision and in-situ reconstruction with bifurcated Dacron silvergrat and antibiotics for life. One year after the patient develop bilateral pulsatile groin mass with inflammatory signs and fever. The computed tomography showed signs of prosthetic infection, aposition of D3 duodenal portion with the underlying prosthesis. The patient is submitted a total graft excision, fistulectomy with duodenojejunostomy and an in situ aortic reconstruction with a Y graft tailored from a self-made tube graft from bovine pericardium and endarterectomized superficial femoral arteries. The patient underwent a 45 days antibiotic regimen and it was discharged with an overall good condition. Discussion and Conclusion: Patients with infectious aortic disease present in a frail state and with high risk of mortality and morbidity. Because of their off-the-shelf availability, handling properties, and freedom from reinfection and durability, self-made bovine pericardial grafts are an useful option in urgent reconstruction of vascular infections. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019-05-15T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48750/acv.161 oai:ojs.acvjournal.com:article/161 |
url |
https://doi.org/10.48750/acv.161 |
identifier_str_mv |
oai:ojs.acvjournal.com:article/161 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://acvjournal.com/index.php/acv/article/view/161 https://doi.org/10.48750/acv.161 http://acvjournal.com/index.php/acv/article/view/161/122 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2019 Angiologia e Cirurgia Vascular info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2019 Angiologia e Cirurgia Vascular |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
publisher.none.fl_str_mv |
Sociedade Portuguesa de Angiologia e Cirurgia Vascular |
dc.source.none.fl_str_mv |
Angiologia e Cirurgia Vascular; Vol. 14 No. 4 (2018): December; 347-350 Angiologia e Cirurgia Vascular; Vol. 14 N.º 4 (2018): Dezembro; 347-350 2183-0096 1646-706X reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799129848885542912 |