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Conservative Surgery for Aortic Graft Infection

Surgery for aortic graft infection is a major challenge often characterized by the need for ingenuity and improvisation. Traditional treatment is by total graft excisionand extra-anatomic bypass. In situ replacement of the infected graft using either autogenous tissue or antibloticimpregnated Dacron is effective in selected cases but it is not clear when such conservative treatment may be employed. Graft excision and thorough debridement of infected tissue are Important. whichever technique is used. It would seem unwise to perform insitu reconstruction unless the remaining operative field is free from contamination. When In situ replacement is selected. a rifampicin-soaked Dacron graft is the easy option. but large studies will be needed to determine whether this is a suitable long-term alternative to conventional treatment. Copyright © 1996 The International Society for Cardiovascular Surgery.