Successful treatment of an infected new vascular graft

Abstract

A 71-year old male who underwent total aortic arch replacement using a newly developed uncoated vascular prosthesis (Triplex®) developed postoperative mediastinitis due to a methicillin-resistant Staphylococcus infection. The Triplex® vascular prosthesis has a unique three-layer structure with a non-porous elastomer middle layer material and has several advantages over more traditional prosthesis, namely, good manipulability, good patency, dilatation resistance, and low inflammatory tissue reaction. This is the first reported case of a postoperative prosthesis infection that was successfully treated by omentum wrapping and closed irrigation with triphenylmethane dye. Bacterial cultures of blood samples were negative throughout the course of treatment, and 8 months after the initial operation. Computer tomographs revealed no evidence of infection or anastomotic pseudoaneurysms. In conclusion, the combination of omentum wrapping and the closed irrigation procedure using triphenylmethane dye can be considered to be an effective treatment for Triplex® graft infection.