Self-Made Bovine Pericardial Tube Grafts for the Treatment of Abdominal Aortic Infections

Background: Aortic infections are uncommon but life-threatening diseases. The material of choice for aortic reconstruction is still a matter of debate. The aim of this study is to examine the short-and mid-term outcomes in the treatment of abdominal aortic infections using self-made bovine pericardium tube grafts.Methods: This retrospective, single-center study collected all patients who underwent in situ abdominal aortic reconstruction using self-made bovine pericardial tube grafts between February 2020 and December 2021 in a tertiary care center. Patient comorbidities, symptoms, radiological, bacteriological, and perioperative findings, as well as postoperative outcomes, were analyzed.Results: Bovine pericardial aortic tube grafts were used in 11 patients (10 males, median age 68.7 years). Two patients presented with a native aortic infection, and 9 had graft infections (4 bypass grafts, 4 endografts, and a plurioperated patient who had undergone both endovas-cular and open procedures). There were 2 emergent surgeries due to infectious aneurysm rup-tures. All patients were symptomatic, and the most frequent clinical finding was lumbar or abdominal pain (36%), followed by wound infection (27%), and fever (18%). Seven bifurcated and 4 straight pericardial tube grafts were needed. Purulent drainage was obtained around the previous graft or in the aneurysmal sac in 7 cases; intraoperative cultures were positive in 6 cases (gram + bacteria). Two patients died in the immediate postoperative period (periopera-tive mortality 18%; urgent procedures 50%; scheduled procedures 11%). One patient had a ma-jor complication due to bilateral severe acute respiratory syndrome coronavirus 2 pneumonia. There was 1 single reintervention to control hemostasis due to bleeding nongraft-related. The median follow-up was 14.1 months (3e24 months). Conclusions: Our preliminary experience in the treatment of abdominal aortic infections by in situ reconstruction with self-made bovine pericardial tube grafts shows promising results. These should be confirmed in the long term.

Automated summary

This study examined the short- and mid-term outcomes of treating abdominal aortic infections using self-made bovine pericardium tube grafts. The results showed promising results in the treatment of abdominal aortic infections with these grafts, but long-term follow-up is needed for further confirmation.