AORTIC GRAFT INFECTION .2. MICROBIOLOGY, TREATMENT, AND PREVENTION

Infection involving an aortic prosthesis is among the most challenging diagnostic and therapeutic complications in vascular surgery. Delays in diagnosis and treatment are associated with decreased patient survival. Graft excision and revascularization by an extra-anatomic route or autogenous repair is associated with a mortality of 15% to 20% and an amputation rate of less than 10%. Carefully selected patients with late-appearing infection caused by Staphylococcus epidermidis can be safely treated by in situ graft. replacement. Early diagnosis, coupled with surgical intervention that eradicates the infectious process, are key elements for successful treatment. In the majority of patients, long-term, infection-free survival, is possible but requires careful surveillance for persistent or recurrent infection.