Contemporary management of infrarenal aortic graft infection: early and late results in 82 patients

Management of aortic graft infection (AGI) remains contentious. The purpose of this study was to evaluate factors of clinical significance which influence the outcome of different treatment modalities for AGI. From 2000 to 2008, 82 consecutive patients were treated for AGI. In situ reconstruction (ISR) was performed in 63 patients with various conduits, extra-anatomic reconstruction (EAR) in 11, conservative treatment in five and resection without reconstruction in three. The perioperative mortality rate for the series (33%) was similar for EAR and ISR and was higher in patients with secondary aortoenteric fistula (P<0.001) in those undergoing emergency aortic reconstruction (P<0.001) and in AGI caused by virulent organisms (P<0.05). Fifteen (27%) of the surviving patients developed a recurrence of infection IRO. EAR patients were more exposed to RI (P<0.04). In conclusion, ISR may be more appropriate for AGI, but this study cannot draw a conclusion relating to the optimal conduit for ISR.