Intraoperative vacuum-assisted closure following in situ graft replacement for an infected thoracic aortic graft

Hosoyama, Katsuhiro; Kawamoto, Shunsuke; Motoyoshi, Naotaka; Saiki, Yoshikatsu

doi:10.1016/j.jtcvs.2015.05.061

Cited by 7 publications

(3 citation statements)

References 5 publications

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“…However, if the condition of the patient is considerably poor, there is an option to perform vacuum-assisted wound closure (VAC) therapy and omental transfer, avoiding re-replacement with prosthetic graft or allogeneic cryopreserved tissue (homograft). 1514,1515 There are some points to note when performing the re-median sternotomy that is required for the open surgery described above. Unlike reoperation in valvular disease, coronary artery disease, or congenital heart disease, it is not uncommon for the enlarged aorta itself or prosthetic graft replaced in the previous surgery to adhere firmly to the back of the sternum.…”

Section: Reoperation ▋ 31 After Open Surgery (Table 45)mentioning

confidence: 99%

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Ogino,

Iida,

Akutsu

et al. 2023

Circ J

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▋ 1.3.2 Location of AneurysmsAneurysms are classified into thoracic, thoracoabdominal, and abdominal aneurysms, which are further classified as follows: Thoracic: It is further classified into ascending, arch, and descending aortic aneurysms. Thoracoabdominal: The Crawford classification based on the range of replacement in thoracoabdominal aneurysm surgery (Figure 5). Abdominal: Abdominal aortic aneurysms are classified using the renal artery as the reference into the supra-and infra-renal segments. ▋ 1.3.3 CauseBased on the cause of the aneurysm, aortic aneurysms are classified into atherosclerotic, traumatic, inflammatory, infected, congenital, etc. Most of them are atherosclerotic aortic aneurysms. Advance Publication13 JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection is indicated for saccular aneurysms regardless of the size of the thickening (See PQ 1). Inflammatory aortic aneurysm: Aneurysm caused by inflammation. Although, in general, "inflammation" is a concept that includes infection, however, inflammatory aortic aneurysm does not include the aortic aneurysm with infection. Inflammatory periaortitis: A case with inflammation around the aorta but with less aortic dilation that does not meet the criteria of aneurysm. Infected aortic aneurysm: Aneurysm caused by infection. Rupture: Extravascular blood leakage due to damage to the arterial wall. Impending rupture: The absence of damage to the arterial wall despite the presence of aneurysmal pain. ▋ 4.2 Aortic DissectionDissecting aneurysm: Aortic dissection with aneurysmal formation. A general term that was previously used for overall aortic dissection. However, because in many cases with aortic dissection in acute phase does not meet the criteria for an aneurysm, aortic dissection in acute phase is now called, "acute aortic dissection." True lumen: The original arterial cavity. False lumen: A new cavity formed in the arterial wall (the term "dissection cavity" is not appropriate). Dissection flap: The (intima-media) septal wall. It used to be called "intimal dissection." However, it actually consists of intima and a part of the media. Tear: Intimal and medial tears of aortic dissection which is the site of communication between the true lumen and the false lumen. "Intimal tear" is also regularly used as a synonym for "tear". Entry: A site where blood flow enters from the true lumen to the false lumen. Re-entry: A site where blood flow enters from the false lumen to the true lumen. ("communication window" that is also used as a term for both entry and re-entry) Aortic dissection with patent false lumen: It is a synonym for "communicating aortic dissection", a type of aortic dissection in Europe classification. It is also called "classic dissection" or "double barrel aorta." One of the three types of aortic dissection in Japanese Aortic dissection with thrombosed false lumen: It is a synonym for "noncommunicating aortic dissection", a type of aortic dissection in Europe classification. One of the three ty...

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Section: Reoperation ▋ 31 After Open Surgery (Table 45)mentioning

confidence: 99%

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Ogino,

Iida,

Akutsu

et al. 2023

Circ J

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“…However, the ultimate and definitive treatment remains high-risk surgical re-exploration and explantation of the infected material; yet, even in major Aortic Centres, mortality outcomes are poor-current reported rates vary between 14% and 55%, depending on strategy, timing and approach [14]. Adjunctive interventions may be of great help, including graft coverage [15], vacuumassisted closure [16], infection-resistant graft materials [17], and lifelong suppressive therapy [18]. Long-term follow-up is also important because of recurrent infection in around 10-15% cases, and persistent fungal infection [19].…”

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Proximal Aortic Graft Infection: Time for Treatment in an Aortic Centre?

El‐Gamel

2022

Heart, Lung and Circulation

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“…In this small series, Hosoyama and colleagues 1 have described their use of negative pressure wound therapy and delayed sternal closure after resection and replacement of infected ascending aortic grafts to decrease the risk of recurrent infection. They performed daily dressing changes at the intensive care unit (ICU) bedside for 9 days, without hemorrhagic complications.…”

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confidence: 99%

An aggressive, novel approach using a vacuum-assisted system to treat thoracic aortic graft infection

Kim

Szeto

2015

The Journal of Thoracic and Cardiovascular Surgery

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Intraoperative vacuum-assisted closure following in situ graft replacement for an infected thoracic aortic graft

Cited by 7 publications

References 5 publications

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection

Proximal Aortic Graft Infection: Time for Treatment in an Aortic Centre?

An aggressive, novel approach using a vacuum-assisted system to treat thoracic aortic graft infection

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