Aortic Graft Complicated by a Corynebacterium Striatum Infection Due to Previous Type IV Thoraco Abdominal Aortic Aneurysm Repair

Abstract

We report successful management of aortic graft infection without graft explanation or extra-anatomic bypass. A 61 year-old male who had undergone surgical repair of a type IV thoraco-abdominal aortic aneurysm presented with left flank pain and raised inflammatory markers following graft implantation. CT scanning revealed a left psoas fluid collection. Graft infection was diagnosed. A radio-guided drainage and conservative management, with irrigation drain placement was undertaken with preservation of the aortic graft. There was no evidence of recurrent infection after follow-up at 34 months. Aortic endograft infection may be managed by surgical or radio-guided drainage, antibiotic irrigation of the graft and systemic antibiotic therapy without graft removal.

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R. Gabrielli, M. Rosati, G. Caselli, A. Carra and A. Siani, "Aortic Graft Complicated by a Corynebacterium Striatum Infection Due to Previous Type IV Thoraco Abdominal Aortic Aneurysm Repair," World Journal of Cardiovascular Surgery, Vol. 1 No. 2, 2011, pp. 5-10. doi: 10.4236/wjcs.2011.12002.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] P. W. Hoffert, S. Gensler and H. Haimovici, “Infection Complicating Arterial Grafts,” Archives of Surgery, Vol. 90, No. 3, 1965, pp. 427-435. doi:10.1001/archsurg.1965.01320090105024
[2] D. E. Szilagyi, R. F. Smith, J. P. Elliott and M. P. Vrandecic, “Infection in Arterial Reconstruction with Synthetic Grafts,” Annals of Surgery, Vol. 176, No. 3, 1972, pp. 321-333. doi:10.1097/00000658-197209000-00008
[3] J. Goldstone and W. S. Moore, “Infection in Vascular Prostheses: Clinical Manifestations and Surgical Management,” Annals of Surgery, 1972, Vol. 176, No. 2, pp. 225-233.
[4] P. J. O’Hara, N. R. Hertzer, E. G. Beven and L. P. Krajewski, “Surgical Management of Infected Abdominal Aortic Grafts: Review of 25-Year Experience,” Journal of Vascular Surgery, Vol. 3, No. 5, 1986, pp. 725-731.
[5] J. J. Earnshaw, “Infection after Vascular Reconstruction-Hard Graft for Surgeons,” Surgical Infections, Vol. 3, No. 3, 1991, pp. 4-6.
[6] A. E. Brown, “Other Corynebacteria and Rhodococcus,” In: G. L. Mandell, J. E. Bennett and R. Dolin, Eds., Principles and Practice of Infectious Diseases, 5th Edition, Churchill Livingstone, New York, 2000, pp. 2198-2208.
[7] S. M. Markowitz and P. E. Coudron, “Native Valve Endocarditis Caused by an Organism Resembling Corynebacterium Striatum,” Journal of Clinical Microbiology, Vol. 28, No. 1, 1990, pp. 8-10.
[8] D. W. Rufael and S. E.Cohn, “Native Valve Endocarditis Due to Corynebacterium Striatum: Case Report and Review,” Clinical Infectious Diseases, Vol. 19, No. 6, 1994, pp. 1054-1061. doi:10.1093/clinids/19.6.1054
[9] G. E. Morris, P. J. Friend, D. J. Vassallo, M. Farrington, S. Leapman and C. R. G. Quick, “Antibiotic Irrigation and Conservative for Major Aortic Graft Infection,” Journal of Vascular Surgery, Vol. 20, No. 1, 1994, pp. 88-95. doi:10.1016/0741-5214(94)90179-1
[10] P. R. Vogt, H. P. Brunner-La Rocca, T. Carrel, L. K. von Segesser, C. Ruef, J. Debatin, et al., “Cryopreserved Arterial Allografts in the Treatment of Major Vascular Infection: A Comparison with Conventional Surgical Techniques,” The Journal of Thoracic and Cardiovascular Surgery, Vol. 116, No. 6, 1998, pp. 965-972. doi:10.1016/S0022-5223(98)70048-0
[11] P. Tattevin, A. C. Cremieux, C. Muller-Serieys and C. Carbon, “Native Valve Endocarditis Due to Corynebacterium Striatum: First Reported Case of Medical Treatment Alone,” Clinical Infectious Diseases, Vol. 23, No. 6, 1996, 1330-1331. doi:10.1093/clinids/23.6.1330
[12] U. F. W. Blaisde and A. D. Hall, “Axillary-Femoral Artery Bypass for Lower Extremity Ischemia,” Surgery, Vol. 54, No. 10, 1963, pp. 563-568.
[13] J. H. Conn, J. D. Hardy, C. M. Chavez and W. R. Fain, “Infected Arterial Grafts: Experience in 22 Cases with Emphasis on Unusual Bacteria and Technics,” Annals of Surgery, Vol. 171, No. 5, 1970, pp. 704-714. doi:10.1097/00000658-197005000-00009
[14] W. J. Liekweg and L. J. Greenfield, “Vascular Prosthetic Infections: Collected Experience and Results of Treatment,” Surgery, Vol. 81, No. 3, 1977, pp. 335-342.
[15] J. M. Comfier, A. S. Ward, P. Lagneau and D. Janneau, “Infection Complicating Aortoiliac Surgery,” Journal of Cardiothoracic Surgery, Vol. 21, No. 3, 1980, pp. 303-314.
[16] R. E. Casali, W. E. Tucker, B. W. Thompson and R. C. Read, “Infected Prosthetic Grafts,” Archives of Surgery, Vol. 115, No. 5, 1980, pp. 577-580. doi:10.1001/archsurg.1980.01380050007003
[17] A. R. Downs, C. R. Lye and G. MacKean, “Graft Infections in Aortoiliac Arterial Reconstructions,” Canadian Journal of Surgery, Vol. 26, No. 4, 1983, pp. 328-329.
[18] J. J. Ricotta, G. L. Faggioli, A. Stella, et al., “Total Excision and Extra-Anatomic Bypass for Aortic Graft Infection,” The American Journal of Surgery, Vol. 162, No. 2, 1991, pp. 145-149. doi:10.1016/0002-9610(91)90177-F
[19] P. R. Vogt, H. P. Brunner-LaRocca, M. Lachat, C. Ruef and M. I. Turina, “Technical Details with the Use of Cryopreserved Arterial Allografts for Aortic Infection: Influence on Early and Midterm Mortality,” Journal of Vascular Surgery, Vol. 35, No. 1, 2002, pp. 80-86.
[20] T. Bisdas, M. Bredt, M. Pichlmaier, T. Aper, M. Wilhelmi, S. Bisdas, A. Haverich and O. E. Teebken, “Eight-Year Experience with Cryopreserved Arterial Homografts for the in Situ Reconstruction of Abdominal Aortic Infections,” Journal of Vascular Surgery, Vol. 52, No. 2, 2010, pp. 323-330. doi:10.1016/j.jvs.2010.02.277
[21] D. E. Szilagyi, F. J. Rodriguez, R. F. Smith and J. P. Elliott, “Late Fate of Arterial Allografts. Observations 6 to 15 Years after Implantation,” Archives of Surgery, Vol. 101, No. 6, 1970, pp. 721-733. doi:10.1001/archsurg.1970.01340300077014
[22] E. Kieffer, A. Bahnini, F. Koskas, C. Ruotolo, D. Le Blevec and D. Plissonnier, “In Situ Allograft Replacement of Infected Infrarenal Aortic Prosthetic Grafts: Results in Forty-Three Patients,” Journal of Vascular Surgery, Vol. 17, No. 2, 1993, pp. 349-355. doi:10.1016/0741-5214(93)90420-Q

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