A Case of Ruptured Cryopreserved Homograft 7 Months after Implantation / 日本心臓血管外科学会雑誌

Infectious abdominal aortic aneurysm is a relatively rare disease, and there is no consensus regarding its surgical treatment. Medical infectious control should be concerned comparison with surgical treatment if there is sepsis, however we sometimes have no other choice but emergency operation for uncontrollable cases. In many reports, cryopreserved homografts were used as <i>in</i>-<i>situ </i>alternative grafts for infectious aortic aneurysms because they had some merits such as anti-infectious effects, suitability and so on. However the number of <i>in-situ </i>cryopreserved homograft replacement cases are few, and the long term result is unclear. We encountered a ruptured cropreserved homograft case 7 months after urgent <i>in-situ </i>cryopreserved homograft replacement. We report the case and refer to the relevans literature.

Three Cases of Infected Abdominal Aortic Aneurysm and <i>In</i>-<i>Situ </i>Repacement of the Affected Segment with a Prosthesis or Cryopreserved Arterial Homograft / 日本心臓血管外科学会雑誌

We encountered three cases of infra-renal infected abdominal aortic aneurysm in 2007 and 2008. Preoperative blood culture was positive in two of the three patients. All of the patients presented with fever of unknown origin. We replaced the affected segment of the abdominal aorta with a synthetic graft in 1 patient, and with a cryopreserved arterial homograft in the remaining 2 patients. An infected abdominal aortic aneurysm is a life-threatening condition. Diagnosis is often difficult, and emergency surgery may be necessitated by rupture of the aneurysm. Our experience suggests that computed tomography is effective for the diagnosis of infected aneurysms. The most effective surgical technique consists of complete resection of the aneurysm, <i>in</i>-<i>situ </i>replacement of the affected aortic segment with a synthetic graft or homograft, and omental coverage.