Technical details with the use of cryopreserved arterial allografts for aortic infection: Influence on early and midterm mortality

Vogt, Paul; Brunner‐LaRocca, Hans‐Peter; Lachat, Mario; Ruef, C.; Turina, Marko

doi:10.1067/mva.2002.118818

Cited by 54 publications

(36 citation statements)

References 20 publications

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“…Cryopreservation has improved the permanence of allografts, but degeneration, possible aneurysmatic dilatation, and subsequent rupture remain challenging 22, 26, 27, 28. Also, availability and costs limit more widespread use.…”

Section: Discussionmentioning

confidence: 99%

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Heinola

Sörelius

Wyss

et al. 2018

JAHA

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BackgroundThe treatment of mycotic abdominal aortic aneurysm requires surgery and antimicrobial therapy. Since prosthetic reconstructions carry a considerable risk of reinfection, biological grafts are noteworthy alternatives. The current study evaluated the durability, infection resistance, and midterm outcome of biological grafts in treatment of mycotic abdominal aortic aneurysm.Methods and ResultsAll patients treated with biological graft in 6 countries between 2006 and 2016 were included. Primary outcome measures were 30‐ and 90‐day survival, treatment‐related mortality, and reinfection rate. Secondary outcome measures were overall mortality and graft patency. Fifty‐six patients (46 males) with median age of 69 years (range 35–85) were included. Sixteen patients were immunocompromised (29%), 24 (43%) had concomitant infection, and 12 (21%) presented with rupture. Bacterial culture was isolated from 43 (77%). In‐situ aortic reconstruction was performed using autologous femoral veins in 30 patients (54%), xenopericardial tube‐grafts in 12 (21%), cryopreserved arterial/venous allografts in 9 (16%), and fresh arterial allografts in 5 (9%) patients. During a median follow‐up of 26 months (range 3 weeks–172 months) there were no reinfections and only 3 patients (5%) required assistance with graft patency. Thirty‐day survival was 95% (n=53) and 90‐day survival was 91% (n=51). Treatment‐related mortality was 9% (n=5). Kaplan–Meier estimation of survival at 1 year was 83% (95% confidence interval, 73%–94%) and at 5 years was 71% (52%–89%).ConclusionsMycotic abdominal aortic aneurysm repair with biological grafts is a durable option for patients fit for surgery presenting an excellent infection resistance and good overall survival.

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Section: Discussionmentioning

confidence: 99%

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Heinola

Sörelius

Wyss

et al. 2018

JAHA

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“…In situ reconstruction with use of a prosthetic graft is attended by a greater risk of graft infection than extra-anatomical bypass procedure. Compared to synthetic grafts, the use of cryopreserved grafts has the advantage of low vulnerability to infection and limited immune response with better viability [28, 29]. This procedure is limited by its cost and the fact that it is not applicable in urgent situations because it needs to be ordered from an international graft banking center.…”

Section: Discussionmentioning

confidence: 99%

Infrarenal Infected Aortic Aneurysm Caused by Streptococcus pyogenes

Cherbanyk

Menth

Egger

et al. 2017

Case Reports in Surgery

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Infectious aneurysm is a rare entity associated with significant morbidity and mortality. Current knowledge on pathogenesis, outcome, diagnosis, management, and follow-up remains debatable. We report the case of a patient with Streptococcus pyogenes aneurysm who was successfully treated with a homograft implant and discuss microbiological characteristics, diagnostic methods, and treatment options currently available for this serious disease.

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“…In their latest article Vogt et al [37]demonstrated that the viability of cryopreserved allografts preserved until after implantation could enhance the resistance to bacteria. In this regard, we think that the results of our study may contribute to improving surgical treatment for infectious diseases in the cardiovascular system, especially improving the repair of lesions in acute postoperative periods.…”

Section: Discussionmentioning

confidence: 99%

Enhancement of Cell Viability in Cryopreserved Rat Vascular Grafts by Administration of Regenerating Gene <i>(Reg)</i> Inducers

Kiji¹,

Dohi

Nishizaki³

et al. 2003

J Vasc Res

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The regenerative capacity of viable cells remaining in cryopreserved vascular allografts is still unclear. Recently, the regenerating gene (Reg) has been documented to play an important role in various regenerating tissues. Here we show the possibility of Reg induction for the enhancement of cryopreserved vascular allograft viability. Cryopreserved rat aortae were isografted or allografted heterotopically. Fresh isografts were also tested. The transplants were retrieved 3, 6, 9, and 12 days after implantation and the intragraft Reg mRNA was measured by a real-time quantitative reverse transcriptional polymerase chain reaction method. Reg expression was not detected before implantation. Reg expression in cryopreserved isografts gradually increased after transplantation, whereas in fresh isografts or cryopreserved allografts it decreased over time after initial expression. Daily administration of 0.5 g/kg nicotinamide (an agent known to be a potent inducer of Reg) induced intragraft Reg mRNA in cryopreserved allografts (p < 0.05) accompanied by augmentation of the intragraft cell population. Daily administration of 0.5 mg/kg FK506 (an immunosuppressant) induced intragraft Reg mRNA both in cryopreserved isografts and allografts (p < 0.01). We conclude that Reg-inductive therapy shows promise as a novel strategy for enhancing the viability of vascular allografts. Moreover, FK506 may be involved in tissue regeneration as well as immunosuppression.

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Technical details with the use of cryopreserved arterial allografts for aortic infection: Influence on early and midterm mortality

Abstract: In situ repair with cryopreserved arterial allografts achieves excellent early and late results in the treatment of aortic infection. However, distinct allograft-related technical problems had to be overcome to improve the outcome of patients with major vascular infections.

Cited by 54 publications

References 20 publications

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Open Repair of Mycotic Abdominal Aortic Aneurysms With Biological Grafts: An International Multicenter Study

Infrarenal Infected Aortic Aneurysm Caused by Streptococcus pyogenes

Enhancement of Cell Viability in Cryopreserved Rat Vascular Grafts by Administration of Regenerating Gene <i>(Reg)</i> Inducers

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