Diagnosis and management of aortic graft infection

Abstract

This report summarizes the currently available methods of diagnosing and treating aortic graft infections. These infections tend to present in subtle ways; therefore, no single diagnostic test is appropriate for all patients. Available imaging techniques have a wide spectrum of sensitivity and specificity. Complementary tests may be necessary to confirm the diagnosis, determine the extent of infection, and assist with operative planning. Once localized, the infectious organism should be cultured. Treatment should be highly individualized and determined by the virulence of the infectious organism, the extent of infection, and the medical status of the patient. Whereas graft excision and extra-anatomic revascularization remains the "gold standard" for treatment of aortic graft infection, the use of in situ replacement with autogenous vein has been shown to be an excellent alternative. In very limited circumstances, in situ replacement with allograft or rifampin-bonded prosthesis may be acceptable.