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. 2022 Feb 21;34(3):378-385.
doi: 10.1093/icvts/ivab337.

Superior vena cava graft infection in thoracic surgery: a retrospective study of the French EPITHOR database

Laura Filaire  1 , Olaf Mercier  2 , Agathe Seguin-Givelet  3 , Olivier Tiffet  4 , Pierre Emmanuel Falcoz  5 , Pierre Mordant  6 , Pierre-Yves Brichon  7 , Philippe Lacoste  8 , Axel Aubert  9 , Pascal Thomas  10 , Françoise Le Pimpec-Barthes  11 , Ioana Molnar  12 , Magali Vidal  13 , Marc Filaire  1 , Géraud Galvaing  1
Affiliations

Superior vena cava graft infection in thoracic surgery: a retrospective study of the French EPITHOR database

Laura Filaire et al. Interact Cardiovasc Thorac Surg. .

Abstract

Objectives: To report our experience on the management of superior vena cava graft infection.

Methods: Between 2001 and 2018, patients with superior vena cava synthetic graft or patch reconstruction after resection of intrathoracic tumours or benign disease were selected retrospectively from the French EPITHOR database and participating thoracic centres. Our study population includes patients with superior vena cava graft infection, defined according to the MAGIC consensus. Superior vena cava synthetic grafts in an empyema or mediastinitis were considered as infected.

Results: Of 111 eligible patients, superior vena cava graft infection occurred in 12 (11.9%) patients with a polytetrafluoroethylene graft secondary to contiguous contamination. Management consisted of either conservative treatment with chest tube drainage and antibiotics (n = 3) or a surgical graft-sparing strategy (n = 9). Recurrence of infection appears in 6 patients. Graft removal was performed in 2 patients among the 5 reoperated patients. The operative mortality rate was 25%.

Conclusions: Superior vena cava graft infection may develop as a surgical site infection secondary to early mediastinitis or empyema. Graft removal is not always mandatory but should be considered in late or recurrent graft infection or in infections caused by aggressive microorganisms (virulent or multidrug resistant bacteria or fungi).

Keywords: Empyema; Graft infection; Mediastinal tumours; Mediastinitis; Non-small-cell lung cancer; Superior vena cava reconstruction.

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Figures

Figure 1:
Figure 1:
Flow chart of the study population. SVC: superior vena cava.
Figure 2:
Figure 2:
Kaplan–Meier curve showing overall survival rate for all patients (A) and for each group (B). Dotted line represents the median survival rate.
Figure 3:
Figure 3:
Proposed algorithm for the management of superior vena cava graft infection.
None
See this image and copyright information in PMC

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