Endograft Infection Due to Secondary Aortoenteric Fistula Treated With Custom-Made Bovine In Situ Aortic Bifurcation Graft

Abstract

Purpose:: To increase awareness of the clinical presentation, diagnostic workup, and treatment options for endograft infections.

Case report:: A 75-year-old male patient was admitted with suspected endograft infection 4 years after endovascular aortic aneurysm repair (EVAR). Although preoperative diagnostics showed no definitive signs of endograft infection, eventual surgical exposure of the endograft revealed signs of advanced inflammation, including the unexpected finding of an aortoduodenal fistula.

Conclusion:: A detailed evaluation of patient history and clinical examination, performed as a part of routine follow-ups, may be beneficial in identifying possible severe complications after EVAR early on. Regarding options for aortic reconstruction in case of endograft infection, bovine pericardium deserves consideration as a promising, feasible, and easily available graft material.

Keywords: abdominal aortic aneurysm repair; aortoenteric fistula; bovine pericardium graft; endograft infection; endovascular aneurysm repair; mycotic aortic aneurysm.