Outcomes of Mediastinal Transposition of the Greater Omentum for Treatment of Infected Prostheses of the Ascending Aorta and the Aortic Arch
Presented During:
Thursday, April 25, 2024: 5:38PM - 7:00PM
Sheraton Times Square
Posted Room Name:
Central Park
Abstract No:
P0243
Submission Type:
Abstract Submission
Authors:
Leonard Pitts (1), Miralem Pasic (1), Leonhard Wert (1), Gaik Nersesian (1), Julius Kaemmel (1), Semih Buz (1), Jörg Kempfert (1), Volkmar Falk (1)
Institutions:
(1) German Heart Center Berlin, Berlin, Germany
Submitting Author:
Leonard Pitts
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German Heart Center Berlin
German Heart Center Berlin
Co-Author(s):
Miralem Pasic
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German Heart Center Berlin
German Heart Center Berlin
Leonhard Wert
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German Heart Center Berlin
German Heart Center Berlin
Gaik Nersesian
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German Heart Center Berlin
German Heart Center Berlin
Julius Kaemmel
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German Heart Center Berlin
German Heart Center Berlin
Semih Buz
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German Heart Center Berlin
German Heart Center Berlin
Jörg Kempfert
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German Heart Center Berlin
German Heart Center Berlin
*Volkmar Falk, MD
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German Heart Center Berlin
German Heart Center Berlin
Presenting Author:
Leonard Pitts
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German Heart Center Berlin
German Heart Center Berlin
Abstract:
Objectives: To evaluate the outcomes of transposition of the omentum into the mediastinum to support the replacement of infected aortic grafts or to cover infected aortic grafts that are not amenable for surgical replacement.
Methods: All patients with thoracic aortic graft infections who underwent mediastinal transposition of the omentum at our institution between 2000 and 2023 were included in this study. Mediastinal transposition of the omentum was performed either after replacement of the infected graft ("curative concept") or solely as bailout procedure by wrapping the infected graft ("palliative concept"). The diagnosis, including computed tomography scans during follow-up, was made according to the criteria of the Management of Aortic Graft Infection Collaboration.
Results: The patient cohort consisted of 31 patients. Both in-hospital and one-year mortality were 0% (n=0) for the curative concept (n=9) compared to 23% (n=5) and 41% (n=9) for the palliative concept (n=22), respectively. There was no graft infection-associated death or recurrence of infection after 3 years in the curative group. Survival was 52% at 3 years in the palliative group, with freedom of infection in 59% of the patients (n=13).
Conclusions: Transposition of the omentum and wrapping of the infected aortic prosthetic graft is a useful bailout strategy for patients who are ineligible for replacement of an infected aortic graft. For radical treatment of aortic graft infections, it may prove an effective supportive therapy.
Methods: All patients with thoracic aortic graft infections who underwent mediastinal transposition of the omentum at our institution between 2000 and 2023 were included in this study. Mediastinal transposition of the omentum was performed either after replacement of the infected graft ("curative concept") or solely as bailout procedure by wrapping the infected graft ("palliative concept"). The diagnosis, including computed tomography scans during follow-up, was made according to the criteria of the Management of Aortic Graft Infection Collaboration.
Results: The patient cohort consisted of 31 patients. Both in-hospital and one-year mortality were 0% (n=0) for the curative concept (n=9) compared to 23% (n=5) and 41% (n=9) for the palliative concept (n=22), respectively. There was no graft infection-associated death or recurrence of infection after 3 years in the curative group. Survival was 52% at 3 years in the palliative group, with freedom of infection in 59% of the patients (n=13).
Conclusions: Transposition of the omentum and wrapping of the infected aortic prosthetic graft is a useful bailout strategy for patients who are ineligible for replacement of an infected aortic graft. For radical treatment of aortic graft infections, it may prove an effective supportive therapy.
Aortic Symposium:
Other - Infectious Aortic Diseases
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