In Situ Ascending Aorta Replacement with Bovine Pericardial Roll Graft for MRSA Graft Infection

Yoshio Hayashida	Noritugu Morishige	Masahiro Osumi
Mituru Fujii

（Division of Cardiovascular Surgery, Saiseikai Fukuoka General Hospital＊, Fukuoka, Japan, and Fukuoka University Hospital Cardiovascular Surgery＊＊, Fukuoka, Japan）

We report an interesting case of thoracic vascular graft infection treated by in situ replacement using bovine pericardial roll. A 65-year-old man who had undergone graft replacement of ascending aorta for acute type A aortic dissection 9 months prior was admitted to our hospital with purulent discharge from his chest wound. Fluid accumulation surrounding the vascular graft was detected by chest CT, and methicillin-resistant Staphylococcus aureus（MRSA）was positive from his blood culture. These findings led to a diagnosis of aortic graft infection. We gave the antibiotics intravenously, opened the abscess cavity around the infected graft, and irrigated with 0.04% gentian violet solution for 6 months, but failed to control the graft infection. Then we did redo replacement of the ascending aortic vascular graft using a bovine pericardial roll graft with a concomitant omental flap wrapping and obtained successful healing of the graft infection. During follow-up, no recurrent infection occurred, however he died of acute subdural hematoma 8 months after surgery. In situ replacement of the infected vascular grafts using a bovine pericardial roll graft with a concomitant omental flap wrapping may be an option for treating infected aortic grafts.

 

Jpn. J. Cardiovasc. Surg. 46:21-24（2017）

Keywords：infected aortic graft;bovine pericardial roll graft;MRSA