The safety of bovine tissue arterial repair in removal of infected prosthetic hemodialysis grafts.
Adult
Aged
Animals
Arteriovenous Shunt, Surgical
/ adverse effects
Blood Vessel Prosthesis
/ adverse effects
Blood Vessel Prosthesis Implantation
/ adverse effects
Carotid Arteries
/ transplantation
Cattle
Databases, Factual
Device Removal
/ adverse effects
Female
Heterografts
Humans
Male
Middle Aged
Pericardium
/ transplantation
Prosthesis-Related Infections
/ diagnosis
Renal Dialysis
Retrospective Studies
Time Factors
Treatment Outcome
Dialysis graft infection
arterial repair in infected fields
dialysis access
dialysis graft removal
prosthetic grafts
renal failure and infection
Journal
The journal of vascular access
ISSN: 1724-6032
Titre abrégé: J Vasc Access
Pays: United States
ID NLM: 100940729
Informations de publication
Date de publication:
May 2021
May 2021
Historique:
pubmed:
11
8
2020
medline:
17
8
2021
entrez:
11
8
2020
Statut:
ppublish
Résumé
More than 400,000 Americans require dialysis, and many receive it via a prosthetic arteriovenous graft. Infection of these grafts is rare, but associated with significant morbidity and mortality. The gold standard is total graft excision with arteriotomy closure. This was previously done with autologous vein, but bovine tissue offers a reasonable alternative. The objective of this article is to evaluate a community hospital experience with bovine tissue arterial repair after total graft excision of infected prosthetic arteriovenous graft. A retrospective review was performed of all cases of infected prosthetic arteriovenous graft removal with bovine tissue arterial repair was performed. Thirteen cases were identified. Presentation, location of graft, and causative organism were reviewed; outcomes including reoperation and mortality were recorded. Of the 13 patients, 12 (92%) had positive cultures of the graft, bloodstream, or wound. Methicillin-resistant Prosthetic arteriovenous graft infection remains a difficult challenge and is associated with significant morbidity and mortality. It presents in a variety of ways, including within an old thrombosed graft. Over the last several years, the causative organism has increasingly become drug resistant. Treatment with total graft excision requires arteriotomy closure, and for this bovine tissue has been demonstrated to be a viable option.
Sections du résumé
BACKGROUND
BACKGROUND
More than 400,000 Americans require dialysis, and many receive it via a prosthetic arteriovenous graft. Infection of these grafts is rare, but associated with significant morbidity and mortality. The gold standard is total graft excision with arteriotomy closure. This was previously done with autologous vein, but bovine tissue offers a reasonable alternative. The objective of this article is to evaluate a community hospital experience with bovine tissue arterial repair after total graft excision of infected prosthetic arteriovenous graft.
METHODS
METHODS
A retrospective review was performed of all cases of infected prosthetic arteriovenous graft removal with bovine tissue arterial repair was performed. Thirteen cases were identified. Presentation, location of graft, and causative organism were reviewed; outcomes including reoperation and mortality were recorded.
RESULTS
RESULTS
Of the 13 patients, 12 (92%) had positive cultures of the graft, bloodstream, or wound. Methicillin-resistant
DISCUSSION
CONCLUSIONS
Prosthetic arteriovenous graft infection remains a difficult challenge and is associated with significant morbidity and mortality. It presents in a variety of ways, including within an old thrombosed graft. Over the last several years, the causative organism has increasingly become drug resistant. Treatment with total graft excision requires arteriotomy closure, and for this bovine tissue has been demonstrated to be a viable option.
Identifiants
pubmed: 32772777
doi: 10.1177/1129729820947870
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM