Banking and Distribution of Large Cryopreserved Arterial Homografts in Brussels: Assessment of 4 Years of Activity by the European Homograft Bank (EHB) with Reference to Implantation Results in Reconstruction of Infected Infrarenal Arterial Prostheses and Mycotic Aneurysms
| Autor: | V. Keppenne, H. Van Damme, G. Wozniak, B. Van Hoeck, André Nevelsteen, Fr. Deuvaert, D. Grandmougin, R. De Geest, P. Vogt, F. Dapper, Yves Goffin, C. Stankowiak |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
medicine.medical_specialty
Aorta business.industry medicine.medical_treatment Aortoenteric fistula 030204 cardiovascular system & hematology Mycotic aneurysm medicine.disease Prosthesis Thrombosis Bronchial Fistula Surgery 03 medical and health sciences 0302 clinical medicine Aneurysm medicine.anatomical_structure medicine.artery Medicine 030212 general & internal medicine Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Vascular Surgery. 32:19-32 |
| ISSN: | 0042-2835 |
| Popis: | In 1991 European Homograft Bank (EHB) initiated a program of cryopreservation and distribution of large arteries to meet a new demand for quality-controlled arterial homo grafts of various sizes. From May 1991 to June 1995, 308 arteries have been registered from 136 donors: 122 brain death cases and 14 cadavers (mean age 34 years, male/female ratio 1.52/1); 263 arteries were cryopreserved (113 aortas, 64 aortic bifur cations, and 86 femoral); 19 were discarded for atherosclerosis (6.7%); 10 batches of arteries were partially or totally discarded because of persistent contamination and further eight batches for positive or doubtful viral serology. One hundred patients were treated in nine European centers with one (N = 69) or more EHB homografts. Indications were: infected prosthesis 70 (17 with aortoenteric fistula); mycotic aneurysm 19 (four ascending aortas, two with bronchial fistula); neoplastic infiltration of subrenal aorta one; extracardiac reconstructions/shunts 10. (continued on next page) (Abstract continued) Results from homograft reconstructions in infected prosthesis or mycotic aneurysm were available in 90 patients. There were 19 early deaths and 24 early complications, three were directly graft-related and included a fatal case of homograft rupture. Sixty- seven vascular cases were followed up from 1 month onward (mean: 16 months): 50 were uneventful; there were nine late deaths, of which two resulted from graft-related digestive hemorrhage; there were eight cases of late complications; three arteries were partly explanted as a result of focal thrombosis. Four patients were lost to follow-up. In the cases of aortoenteric fistula, however, the results were disappointing with only five late survivors of the 16 treated patients. Finally, these results show that cryopreserved arteries seem to perform as well in the midterm as the fresh ones. Both the banking activity of cryopreserved homografts and the short- to mid-term performances of the implants in cases of prosthetic or native arterial infection are very satisfactory, provided no aortoenteric fistula is present. Cryopreserved arteries can also be used for extracardiac shunts and reconstructions. |
| Databáze: | OpenAIRE |
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