Bovine pericardial graft for revascularization of the lower limb following mycotic aneurysm complicating infective endocarditis

Abstract

Mycotic aneurysm, which complicates 2.5%–10% of cases of infectious endocarditis, is an important cause of morbidity and mortality despite antibiotic therapy. Elective surgery remains the cornerstone of the treatment of mycotic aneurysms because of the major risk of rupture. For femoral arteries, the surgical treatment is based on the resection of the aneurysm, with revascularization of the territory downstream. The recommended materials for revascularizations are in the first place biological grafts such as veins grafts (great saphenous vein) and homograft. In our observation, faced with the small diameter of the internal saphenous vein and the lack of homograft availability, and considering the high risk of infection recurrence at the operating site, we opted for the confection of biological graft using bovine pericardium and we think that it will be more resistant to infection than prostheses. According to our knowledge, this technique has not been reported before in the literature, and the validation of this technique on a series of cases and in the long term is necessary.