Early and Mid-Term Results of Native and Abdominal Aortic Graft Infection Treatment via Surgeon-Constructed Porcine Pericardial Aortic Tubes

Angiology. 2024 Jul;75(6):565-575. doi: 10.1177/00033197231162721. Epub 2023 Mar 10.

Abstract

The search for optimal material for aortic infection reconstruction is ongoing. Our study presents the early and mid-term results of surgeon-constructed porcine pericardial tubes in the in-situ reconstruction of abdominal aortic infections, focusing on the safety as well as the durability of surgeon-created tubes. We performed a retrospective analysis of 8 patients treated for native aortic (n = 3) and aortic graft infections (n = 5) with surgeon-created tubes made of porcine pericardium patch (8 × 14 cm NO-REACT Ⓡ, BioIntegral Surgical Inc., Mississauga, ON, Canada). There were 7 males and 1 female, aged 68.5 (±4.8 years). Three patients had an aorto-enteric fistula. Technical success was obtained in all patients. Thirty-day mortality was 12.5% (n = 1). Mid-term follow-up was 12 months (2-63 months). One-year mortality was 37.5% (n = 3). Reintervention rate was 28.5% (n = 2). False aneurysm rate in the follow-up was 14.2% (n = 1). Surgeon-constructed porcine pericardial tubes seem to be a promising alternative as a replacement for native as well as graft-related abdominal aortic infections. The mid-term durability is encouraging, once the infection is controlled in cases with successful fistula repair and in native aortic infections patients. Further observations on larger groups, in longer follow-ups are necessary to confirm these preliminary observations.

Keywords: aneurysm; aorta; endovascular aortic repair; infection; mycotic; pericardium.

MeSH terms

  • Aged
  • Animals
  • Aorta, Abdominal / surgery
  • Bioprosthesis* / adverse effects
  • Blood Vessel Prosthesis Implantation* / adverse effects
  • Blood Vessel Prosthesis Implantation* / instrumentation
  • Blood Vessel Prosthesis* / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pericardium* / surgery
  • Pericardium* / transplantation
  • Prosthesis Design
  • Prosthesis-Related Infections* / surgery
  • Reoperation
  • Retrospective Studies
  • Swine
  • Time Factors
  • Treatment Outcome