Contemporary Outcomes After Partial Resection of Infected Aortic Grafts

Registro completo de metadados
MetadadosDescriçãoIdioma
Autor(es): dc.contributorCase Western Reserve University School of Medicine-
Autor(es): dc.contributorUniversity of California Los Angeles-
Autor(es): dc.contributorSSM Healthcare-
Autor(es): dc.contributorSemmelweis University-
Autor(es): dc.contributorUniversity of Southern California-
Autor(es): dc.contributorUniversity of North Carolina School of Medicine-
Autor(es): dc.contributorUniversity of Arizona-
Autor(es): dc.contributorthe Indiana University Health Physicians Vascular Surgery-
Autor(es): dc.contributorUniversity of Michigan-
Autor(es): dc.contributorUniversity Medical Center Hamburg-Eppendorf-
Autor(es): dc.contributorMilton S. Hershey Medical Center-
Autor(es): dc.contributorJohns Hopkins Hospital-
Autor(es): dc.contributorThe Heart Hospital Baylor Plano-
Autor(es): dc.contributorthe Cardiovascular Surgery Clinic-
Autor(es): dc.contributorUniversity of Messina-
Autor(es): dc.contributorNational & Kapodistrian University of Athens-
Autor(es): dc.contributorUniversity of Patras-
Autor(es): dc.contributorKeio University-
Autor(es): dc.contributorUniversity of Pennsylvania-
Autor(es): dc.contributorVancouver General Hospital & University of British Columbia-
Autor(es): dc.contributorMayo Clinic-
Autor(es): dc.contributorChristiana Health System-
Autor(es): dc.contributorUniversity of Chicago-
Autor(es): dc.contributorUniversity of Washington-
Autor(es): dc.contributorWashington University-
Autor(es): dc.contributorStanford University-
Autor(es): dc.contributorCHU de Poitiers-
Autor(es): dc.contributorBaylor College of Medicine-
Autor(es): dc.contributorMedStar Georgetown University Hospital-
Autor(es): dc.contributorSSM Health St. Louis University-
Autor(es): dc.contributorUniversidade Estadual Paulista (UNESP)-
Autor(es): dc.contributorBeth Israel Deaconness Medical Center-
Autor(es): dc.contributorBrigham and Women's Hospital-
Autor(es): dc.contributorSt. Joseph's Hospital-
Autor(es): dc.contributorMassachusetts General Hospital-
Autor(es): dc.contributorRutgers University-
Autor(es): dc.contributorSan Raffaele Scientific Institute-
Autor(es): dc.contributorKaiser Permanente-
Autor(es): dc.contributorUniversity Heart Center Freiburg-Bad Krozingen Freiburg-
Autor(es): dc.contributorUniversity of Virginia Medical Center-
Autor(es): dc.contributorUniversity of Siena-
Autor(es): dc.contributorKyung Hee University-
Autor(es): dc.contributorGustave Dron Hospital-
Autor(es): dc.contributorCentro Hospitalar de Lisboa Norte-
Autor(es): dc.contributorOhio State University-
Autor(es): dc.contributorUppsala University-
Autor(es): dc.contributorUniversity Hospital of Trieste-
Autor(es): dc.contributorUniversity Hospital of Verona-
Autor(es): dc.contributorUniversity Hospital of Padova-
Autor(es): dc.contributorUniversity of Alabama-
Autor(es): dc.contributorUniversity of California Davis-
Autor(es): dc.contributorUniversity of Florida-
Autor(es): dc.contributorUniversity of Missouri-
Autor(es): dc.creatorJanko, Matthew-
Autor(es): dc.creatorHubbard, Grant-
Autor(es): dc.creatorWoo, Karen-
Autor(es): dc.creatorKashyap, Vikram S.-
Autor(es): dc.creatorMitchell, Megan-
Autor(es): dc.creatorMurugesan, Arun-
Autor(es): dc.creatorChen, Lin-
Autor(es): dc.creatorGardner, Rachel-
Autor(es): dc.creatorBaril, Donald-
Autor(es): dc.creatorHacker, Robert I.-
Autor(es): dc.creatorSzeberin, Zoltan-
Autor(es): dc.creatorElSayed, Ramsey-
Autor(es): dc.creatorMagee, Gregory A.-
Autor(es): dc.creatorMotta, Fernando-
Autor(es): dc.creatorZhou, Wei-
Autor(es): dc.creatorLemmon, Gary-
Autor(es): dc.creatorColeman, Dawn-
Autor(es): dc.creatorBehrendt, Christian-Alexander-
Autor(es): dc.creatorAziz, Faisal-
Autor(es): dc.creatorBlack, James H.-
Autor(es): dc.creatorTran, Kimberly-
Autor(es): dc.creatorDao, Allen-
Autor(es): dc.creatorShutze, William-
Autor(es): dc.creatorGarrett, H. Edward-
Autor(es): dc.creatorDe Caridi, Giovanni-
Autor(es): dc.creatorPatel, Rhusheet-
Autor(es): dc.creatorLiapis, Christos D.-
Autor(es): dc.creatorGeroulakos, George-
Autor(es): dc.creatorKakisis, John-
Autor(es): dc.creatorMoulakakis, Konstantinos-
Autor(es): dc.creatorKakkos, Starvos K.-
Autor(es): dc.creatorObara, Hideaki-
Autor(es): dc.creatorWang, Grace-
Autor(es): dc.creatorStoecker, Jordan-
Autor(es): dc.creatorRhéaume, Pascal-
Autor(es): dc.creatorDavila, Victor-
Autor(es): dc.creatorRavin, Reid-
Autor(es): dc.creatorDeMartino, Randall-
Autor(es): dc.creatorMilner, Ross-
Autor(es): dc.creatorShalhub, Sherene-
Autor(es): dc.creatorJim, Jeffrey-
Autor(es): dc.creatorLee, Jason-
Autor(es): dc.creatorDubuis, Celine-
Autor(es): dc.creatorRicco, Jean-Baptiste-
Autor(es): dc.creatorCoselli, Joseph-
Autor(es): dc.creatorLemaire, Scott-
Autor(es): dc.creatorFatima, Javairiah-
Autor(es): dc.creatorSanford, Jennifer-
Autor(es): dc.creatorYoshida, Winston-
Autor(es): dc.creatorSchermerhorn, Marc L-
Autor(es): dc.creatorMenard, Matthew-
Autor(es): dc.creatorBelkin, Michael-
Autor(es): dc.creatorBlackwood, Stuart-
Autor(es): dc.creatorConrad, Mark-
Autor(es): dc.creatorWang, Linda-
Autor(es): dc.creatorCrofts, Sara-
Autor(es): dc.creatorNixon, Thomas-
Autor(es): dc.creatorWu, Timothy-
Autor(es): dc.creatorChiesa, Roberto-
Autor(es): dc.creatorBose, Saideep-
Autor(es): dc.creatorTurner, Jason-
Autor(es): dc.creatorMoore, Ryan-
Autor(es): dc.creatorSmith, Justin-
Autor(es): dc.creatorIrshad, Ali-
Autor(es): dc.creatorHsu, Jeffrey-
Autor(es): dc.creatorCzerny, Martin-
Autor(es): dc.creatorCullen, Jonathan-
Autor(es): dc.creatorKahlberg, Andrea-
Autor(es): dc.creatorSetacci, Carlo-
Autor(es): dc.creatorJoh, Jin Hyun-
Autor(es): dc.creatorSenneville, Eric-
Autor(es): dc.creatorGarrido, Pedro-
Autor(es): dc.creatorSarac, Timur P.-
Autor(es): dc.creatorRizzo, Anthony-
Autor(es): dc.creatorGo, Michael R.-
Autor(es): dc.creatorBjorck, Martin-
Autor(es): dc.creatorGavali, Hamid-
Autor(es): dc.creatorWanhainen, Anders-
Autor(es): dc.creatorD'Oria, Mario-
Autor(es): dc.creatorLepidi, Sandro-
Autor(es): dc.creatorMastrorilli, Davide-
Autor(es): dc.creatorVeraldi, Gianfranco-
Autor(es): dc.creatorPiazza, Michele-
Autor(es): dc.creatorSquizzato, Francesco-
Autor(es): dc.creatorBeck, Adam-
Autor(es): dc.creatorSt. John, Rebecca-
Autor(es): dc.creatorWishy, Andrew-
Autor(es): dc.creatorHumphries, Misty-
Autor(es): dc.creatorShah, Samir K.-
Autor(es): dc.creatorBack, Martin-
Autor(es): dc.creatorChung, Jayer-
Autor(es): dc.creatorLawrence, Peter F-
Autor(es): dc.creatorBath, Jonathan-
Autor(es): dc.creatorSmeds, Matthew R.-
Data de aceite: dc.date.accessioned2025-08-21T18:45:29Z-
Data de disponibilização: dc.date.available2025-08-21T18:45:29Z-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2022-04-28-
Data de envio: dc.date.issued2021-10-01-
Fonte completa do material: dc.identifierhttp://dx.doi.org/10.1016/j.avsg.2021.07.002-
Fonte completa do material: dc.identifierhttp://hdl.handle.net/11449/222821-
Fonte: dc.identifier.urihttp://educapes.capes.gov.br/handle/11449/222821-
Descrição: dc.descriptionIntroduction: Aortic graft infection remains a considerable clinical challenge, and it is unclear which variables are associated with adverse outcomes among patients undergoing partial resection. Methods: A retrospective, multi-institutional study of patients who underwent partial resection of infected aortic grafts from 2002 to 2014 was performed using a standard database. Baseline demographics, comorbidities, operative, and postoperative variables were recorded. The primary outcome was mortality. Descriptive statistics, Kaplan-Meier (KM) survival analysis, and Cox regression analysis were performed. Results: One hundred fourteen patients at 22 medical centers in 6 countries underwent partial resection of an infected aortic graft. Seventy percent were men with median age 70 years. Ninety-seven percent had a history of open aortic bypass graft: 88 (77%) patients had infected aortobifemoral bypass, 18 (16%) had infected aortobiiliac bypass, and 1 (0.8%) had an infected thoracic graft. Infection was diagnosed at a median 4.3 years post-implant. All patients underwent partial resection followed by either extra-anatomic (47%) or in situ (53%) vascular reconstruction. Median follow-up period was 17 months (IQR 1, 50 months). Thirty-day mortality was 17.5%. The KM-estimated median survival from time of partial resection was 3.6 years. There was no significant survival difference between those undergoing in situ reconstruction or extra-anatomic bypass (P = 0.6). During follow up, 72% of repairs remained patent and 11% of patients underwent major amputation. On univariate Cox regression analysis, Candida infection was associated with increased risk of mortality (HR 2.4; P = 0.01) as well as aortoenteric fistula (HR 1.9, P = 0.03). Resection of a single graft limb only to resection of abdominal (graft main body) infection was associated with decreased risk of mortality (HR 0.57, P = 0.04), as well as those with American Society of Anesthesiologists classification less than 3 (HR 0.35, P = 0.04). Multivariate analysis did not reveal any factors significantly associated with mortality. Persistent early infection was noted in 26% of patients within 30 days postoperatively, and 39% of patients were found to have any post-repair infection during the follow-up period. Two patients (1.8%) were found to have a late reinfection without early persistent postoperative infection. Patients with any post-repair infection were older (67 vs. 60 years, P = 0.01) and less likely to have patent repairs during follow up (59% vs. 32%, P = 0.01). Patients with aortoenteric fistula had a higher rate of any post-repair infection (63% vs. 29%, P < 0.01) Conclusion: This large multi-center study suggests that patients who have undergone partial resection of infected aortic grafts may be at high risk of death or post-repair infection, especially older patients with abdominal infection not isolated to a single graft limb, or with Candida infection or aortoenteric fistula. Late reinfection correlated strongly with early persistent postoperative infection, raising concern for occult retained infected graft material.-
Descrição: dc.descriptionUniversity Hospitals Cleveland Medical Center Case Western Reserve University School of Medicine-
Descrição: dc.descriptionthe Ronald Reagan UCLA Medical Center University of California Los Angeles-
Descrição: dc.descriptionSSM Healthcare-
Descrição: dc.descriptionSemmelweis University-
Descrição: dc.descriptionKeck School of Medicine University of Southern California-
Descrição: dc.descriptionUniversity of North Carolina School of Medicine-
Descrição: dc.descriptionUniversity of Arizona-
Descrição: dc.descriptionthe Indiana University Health Physicians Vascular Surgery-
Descrição: dc.descriptionMichigan Medicine University of Michigan-
Descrição: dc.descriptionUniversity Heart Center Hamburg University Medical Center Hamburg-Eppendorf-
Descrição: dc.descriptionPenn State Heart and Vascular Institute Milton S. Hershey Medical Center-
Descrição: dc.descriptionJohns Hopkins Hospital-
Descrição: dc.descriptionThe Heart Hospital Baylor Plano-
Descrição: dc.descriptionthe Cardiovascular Surgery Clinic-
Descrição: dc.descriptionUniversity of Messina-
Descrição: dc.descriptionNational & Kapodistrian University of Athens-
Descrição: dc.descriptionUniversity of Patras-
Descrição: dc.descriptionKeio University-
Descrição: dc.descriptionUniversity of Pennsylvania-
Descrição: dc.descriptionVancouver General Hospital & University of British Columbia-
Descrição: dc.descriptionMayo Clinic-
Descrição: dc.descriptionChristiana Health System-
Descrição: dc.descriptionUniversity of Chicago-
Descrição: dc.descriptionHarborview Medical Center University of Washington-
Descrição: dc.descriptionWashington University-
Descrição: dc.descriptionStanford University-
Descrição: dc.descriptionCHU de Poitiers-
Descrição: dc.descriptionBaylor College of Medicine-
Descrição: dc.descriptionMedStar Georgetown University Hospital-
Descrição: dc.descriptionSSM Health St. Louis University-
Descrição: dc.descriptionFaculdade de Medicina de Botucatu-Unesp-
Descrição: dc.descriptionBeth Israel Deaconness Medical Center-
Descrição: dc.descriptionBrigham and Women's Hospital-
Descrição: dc.descriptionSt. Joseph's Hospital-
Descrição: dc.descriptionMassachusetts General Hospital-
Descrição: dc.descriptionRobert Wood Johnson Medical School Rutgers University-
Descrição: dc.descriptionVita-Salute University School of Medicine San Raffaele Scientific Institute-
Descrição: dc.descriptionKaiser Permanente-
Descrição: dc.descriptionUniversity Heart Center Freiburg-Bad Krozingen Freiburg-
Descrição: dc.descriptionUniversity of Virginia Medical Center-
Descrição: dc.descriptionUniversity of Siena-
Descrição: dc.descriptionKyung Hee University-
Descrição: dc.descriptionGustave Dron Hospital-
Descrição: dc.descriptionCentro Hospitalar de Lisboa Norte-
Descrição: dc.descriptionWexner Medical Center Ohio State University-
Descrição: dc.descriptionUppsala University-
Descrição: dc.descriptionUniversity Hospital of Trieste-
Descrição: dc.descriptionUniversity Hospital of Verona-
Descrição: dc.descriptionUniversity Hospital of Padova-
Descrição: dc.descriptionUniversity of Alabama-
Descrição: dc.descriptionUniversity of California Davis-
Descrição: dc.descriptionUniversity of Florida-
Descrição: dc.descriptionMichael E. DeBakey Department of Surgery Baylor College of Medicine-
Descrição: dc.descriptionUniversity Hospital University of Missouri-
Descrição: dc.descriptionFaculdade de Medicina de Botucatu-Unesp-
Formato: dc.format202-210-
Idioma: dc.languageen-
Relação: dc.relationAnnals of Vascular Surgery-
???dc.source???: dc.sourceScopus-
Título: dc.titleContemporary Outcomes After Partial Resection of Infected Aortic Grafts-
Tipo de arquivo: dc.typelivro digital-
Aparece nas coleções:Repositório Institucional - Unesp

Não existem arquivos associados a este item.