Aortic Graft Preservation by Debridement and Omental Wrapping

2012 ◽  
Vol 26 (3) ◽  
pp. 423.e1-423.e4 ◽  
Author(s):  
Russell W. Jamieson ◽  
Paul J. Burns ◽  
A. Raymond W. Dawson ◽  
Simon C.A. Fraser
Keyword(s):  
Aortic Graft ◽  
Omental Wrapping ◽  
Graft Preservation

PS01.111: STAGED PEDICLED JEJUNAL TRANSFER AFTER AORTOESOPHAGECTOMY FOR AORTOESOPHAGEAL FISTULA

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 81-81
Author(s):  
Tetsu Nakamura ◽  
Sonoko Ishida ◽  
Hiroshi Hasegawa ◽  
Masashi Yamamoto ◽  
Shingo Kanaji ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Graft Loss ◽  
Surgical Strategy ◽  
Esophageal Reconstruction ◽  
Study Patient ◽  
Aortoesophageal Fistula ◽  
Aortic Graft ◽  
Graft Replacement ◽  
Term Survival ◽  
Omental Wrapping

Abstract Background Aortoesophageal fistula(AEF) had been a critical and life-threatening disease. The surgical strategy which consist of aortic graft replacement with omental wrapping, esophagectomy, and staged esophageal reconstruction achieve circulatory recovery, infection control and long term survival. The objective of this study is to evaluate surgical outcomes of pedicled jejunal transfer with microvascular augmentation as esophageal reconstruction for AEF. Methods 14 patients with aortoesophageal fistula who underwent aortic graft replacement and esophagectomy between 2010 and 2017 at Kobe University Hospital and affiliate hospitals were enrolled in this study. Patient characteristics, operative method and clinical outcomes were obtained by retrospective chart review. Results All 14 patients underwent aortic graft replacement with omental wrapping, esophagectomy and staged esophageal reconstruction. 10 patients (71.4%) successfully underwent staged esophageal reconstruction of pedicled jejunal transfer with microvascular augmentation and showed no leakage and no graft loss. Median survival time in the patients who underwent esophageal reconstruction was 20.3 months from initial operation. Nine of 10 patients were alive but one patient died of sepsis ten months after esophageal reconstruction. Conclusion Aortic graft replacement with omental wrapping and esophaegcotomy play crucial role in the treatment of AEF. Omentum is pedicled by right epiploic artery and vein to prepare good blood flow and sufficient volume of omental wraping and, consequently, stomach without right epiploic artery and vein becomes inappropriate for esophageal conduit. Pedicled jejunal transfer with microvascular augmentation contributes good post-operative outcome. The surgical strategy for AEF, which includes aortic graft replacement with omental wrapping, esophagectomy, and staged esophageal reconstruction by pedicled jejunal transfer microvascular augmentation is feasible and promising. Disclosure All authors have declared no conflicts of interest.

scholarly journals Successful total graft preservation for an infected thoracoabdominal aortic graft

2016 ◽  
Vol 2 (4) ◽  
pp. 178-180
Author(s):  
Joseph Liechty ◽  
Graham N. Albert ◽  
John J. Squiers ◽  
J. Michael DiMaio ◽  
William T. Brinkman ◽  
...  
Keyword(s):  
Aortic Graft ◽  
Graft Preservation

scholarly journals Pedicled omental wrapping of ascending aortic graft following mediastinitis

2021 ◽  
Vol 7 (1) ◽  
pp. 66
Author(s):  
Yatin Arora ◽  
Velayoudam Devagourou ◽  
Ratnesh Kumar
Keyword(s):  
Aortic Graft ◽  
Omental Wrapping

scholarly journals Intra-abdominal aortic graft infection: complete or partial graft preservation in patients at very high risk

2003 ◽  
Vol 38 (6) ◽  
pp. 1199-1204 ◽  
Author(s):  
Keith D Calligaro ◽  
Frank J Veith ◽  
John G Yuan ◽  
Nicholas J Gargiulo ◽  
Matthew J Dougherty
Keyword(s):  
High Risk ◽  
Graft Infection ◽  
Aortic Graft ◽  
Graft Preservation ◽  
Abdominal Aortic ◽  
Aortic Graft Infection ◽  
Very High

Pulmonary Homografts for Aortic Valve Replacement: Long-term Comparison with Aortic Grafts

2011 ◽  
Vol 14 (4) ◽  
pp. 237 ◽  
Author(s):  
Ferdinand Vogt ◽  
Anke Kowert ◽  
Andres Beiras-Fernandez ◽  
Martin Oberhoffer ◽  
Ingo Kaczmarek ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Survival Rates ◽  
Long Term Results ◽  
Rank Test ◽  
Aortic Graft ◽  
Valve Prostheses ◽  
Retrospective Comparative Study

<p><b>Objective:</b> The use of homografts for aortic valve replacement (AVR) is an alternative to mechanical or biological valve prostheses, especially in younger patients. This retrospective comparative study evaluated our single-center long-term results, with a focus on the different origins of the homografts.</p><p><b>Methods:</b> Since 1992, 366 adult patients have undergone AVR with homografts at our center. We compared 320 homografts of aortic origin and 46 homografts of pulmonary origin. The grafts were implanted via either a subcoronary technique or the root replacement technique. We performed a multivariate analysis to identify independent factors that influence survival. Freedom from reintervention and survival rates were calculated as cumulative events according to the Kaplan-Meier method, and differences were tested with the log-rank test.</p><p><b>Results:</b> Overall mortality within 1 year was 6.5% (21/320) in the aortic graft group and 17.4% (8/46) in the pulmonary graft group. In the pulmonary graft group, 4 patients died from valve-related complications, 1 patient died after additional heterotopic heart transplantation, and 1 patient who entered with a primary higher risk died from a prosthesis infection. Two patients died from non-valve-related causes. During the long-term follow-up, the 15-year survival rate was 79.9% for patients in the aortic graft group and 68.7% for patients in the pulmonary graft group (<i>P</i> = .049). The rate of freedom from reoperation was 77.7% in the aortic graft group and 57.4% in the pulmonary graft group (<i>P</i> < .001). The reasons for homograft explantation were graft infections (aortic graft group, 5.0%; pulmonary graft group, 6.5%) and degeneration (aortic graft group, 7.5%; pulmonary graft group, 32.6%).</p><p><b>Conclusion:</b> Our study demonstrated superior rates of survival and freedom from reintervention after AVR with aortic homografts. Implantation with a pulmonary graft was associated with a higher risk of redo surgery, owing to earlier degenerative alterations.</p>

Angioscopic Evaluation of an Endoluminal Aortic Graft: The First Clinical Experience

1995 ◽  
Vol 2 (3) ◽  
pp. 248-254 ◽  
Author(s):  
Bradley B. Hill ◽  
Richard Neville ◽  
Gordon L. Hyde ◽  
Chien-Suu Kuo ◽  
Edward B. Diethrich
Keyword(s):  
Clinical Experience ◽  
Aortic Graft

Performing a PCI through a trifurcated aortic graft: a new challenging access route

2020 ◽  
Vol 68 (5) ◽  
Author(s):  
Gregorio Menzà ◽  
Fabrizio D'Ascenzo ◽  
Matteo Attisani ◽  
Michele La Torre ◽  
Fabio Verzini ◽  
...  
Keyword(s):  
Access Route ◽  
Aortic Graft

scholarly journals Role of PEG35, Mitochondrial ALDH2, and Glutathione in Cold Fatty Liver Graft Preservation: An IGL-2 Approach

2021 ◽  
Vol 22 (10) ◽  
pp. 5332
Author(s):  
Raquel G. Bardallo ◽  
Rui Teixeira da Silva ◽  
Teresa Carbonell ◽  
Emma Folch-Puy ◽  
Carlos Palmeira ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Fatty Liver ◽  
Liver Graft ◽  
Suitable Alternative ◽  
Graft Preservation ◽  
Preservation Solutions ◽  
Microcirculatory Disturbances ◽  
Organ Recovery ◽  
Surgical Manipulations

The total damage inflicted on the liver before transplantation is associated with several surgical manipulations, such as organ recovery, washout of the graft, cold conservation in organ preservation solutions (UW, Celsior, HTK, IGL-1), and rinsing of the organ before implantation. Polyethylene glycol 35 (PEG35) is the oncotic agent present in the IGL-1 solution, which is an alternative to UW and Celsior solutions in liver clinical transplantation. In a model of cold preservation in rats (4 °C; 24 h), we evaluated the effects induced by PEG35 on detoxifying enzymes and nitric oxide, comparing IGL-1 to IGL-0 (which is the same as IGL-1 without PEG). The benefits were also assessed in a new IGL-2 solution characterized by increased concentrations of PEG35 (from 1 g/L to 5 g/L) and glutathione (from 3 mmol/L to 9 mmol/L) compared to IGL-1. We demonstrated that PEG35 promoted the mitochondrial enzyme ALDH2, and in combination with glutathione, prevented the formation of toxic aldehyde adducts (measured as 4-hydroxynonenal) and oxidized proteins (AOPP). In addition, PEG35 promoted the vasodilator factor nitric oxide, which may improve the microcirculatory disturbances in steatotic grafts during preservation and revascularization. All of these results lead to a reduction in damage inflicted on the fatty liver graft during the cold storage preservation. In this communication, we report on the benefits of IGL-2 in hypothermic static preservation, which has already been proved to confer benefits in hypothermic oxygenated dynamic preservation. Hence, the data reported here reinforce the fact that IGL-2 is a suitable alternative to be used as a unique solution/perfusate when hypothermic static and preservation strategies are used, either separately or combined, easing the logistics and avoiding the mixture of different solutions/perfusates, especially when fatty liver grafts are used. Further research regarding new therapeutic and pharmacological insights is needed to explore the underlying mitochondrial mechanisms exerted by PEG35 in static and dynamic graft preservation strategies for clinical liver transplantation purposes.

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