How to treat aortic graft infection? With a special emphasis on xeno-pericardial aortic tube grafts

Infection of a vascular prosthesis or endovascular stent-graft is probably the most serious complication that may occur after implantation and dramatically affects the patient’s outcome. The most common etiology of graft and/or prosthetic valve infection is usually wound-related infection, followed by seeding from distant infection sites (lung, urinary tract). Surgical treatment is almost always required but even after surgery, morbidity can be significant. Operative procedure must be tailored according to the individual patient and to the experience of the surgical team. Complete resection of the infected foreign material with débridement of the surrounding tissue gives most probably the best results. Orthotopic reconstruction is the best option for all thoracic and thoraco-abdominal pathologies and the use of coated prostheses, industrially fabricated bio-conduits, homografts or self-made vascular tubes from xenopericardial tissue has to be discussed from case to case. In some exceptional situations, endovascular stent-graft can be performed as bridging to a more complete treatment if general condition of the patient has to be stabilized.