Eradication of aortic infections with the use of cryopreserved arterial homografts

Background. The surgical treatment of vascular infection is associated with a substantial early and late mortality. Cryopreserved homografts were evaluated for in situ reconstruction in aortic infections. Methods. Between January 1991 and July 1995, homografts were used in 19 patients (mean age, 61 plus or minus 13 years; range, 40-85 years) with mycotic aneurysms (9/19; 47 percent) or infected grafts (10/19; 53 percent) in the thoracic (7/19; 37 percent) or abdominal (12/19; 63 percent) aorta. Sepsis was present preoperatively in 14 of 19 (74 percent) patients, and 18 of 19 (95 percent) had received antibiotic treatment for 6.4 plus or minus 6 months (range, 1-36 months). Up to ten previous vascular procedures had been done in 11 of 19 patients (58 percent). Results. There was one (5.2 percent) early and two (11 percent) late deaths, with one (5.5 percent) of the late deaths being homograft related. The mean hospital stay was 27 plus or minus 26 days (range, 7-84 days). Antibiotics were given postoperatively for 30 plus or minus 12 days (range, 4-84 days). During the follow-up period of 18.6 plus or minus 13 months (range, 7-60 months), there were no instances of reinfection, suture line rupture, homograft stenosis, or anastomotic aneurysms. Conclusions. Cryopreserved arterial homografts allow safe in situ reconstruction, decrease early and midterm mortality, and reduce antibiotic requirements. Early and midterm reoperations are unnecessary.