heart-congress-vascular-biology-2017-posters

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Clin Cardiol J Volume 1 | Issue 1

December 04-05, 2017 Dallas, USA

International Conference on

Heart Congress, Vascular Biology and Surgeon’s Meeting

The management of aortic graft infection

Nicholas M Price

Guy’s & St Thomas’ NHS Foundation Trust, UK

ortic graft and endograft infection (AGI) complicates approximately 1-4% of deployments. At present,

no universally accepted case definition exists and clinical guidelines that are underpinned by high-quality

published evidence are severely lacking. There is general consensus that AGI is diagnosed by a combination of

clinical, radiological and laboratory findings. However, in the current literature, microbiological details are brief

and in a substantial number of cases there is no positive microbiology available to base targeted antimicrobial

treatment upon. Published radiological data are mainly descriptive and the utility of various new diagnostic

imaging modalities remains unclear. The fundamental tenets of management involve removal of the infected

device, revascularization and antimicrobial therapy. However, surgical explanation carries a mortality of 18-30%

and if an infected device is left in situ, mortality approaches 100% within 2 years. The best published surgical

studies are mostly large case series but there are there are no randomised controlled trials evaluating the optimum

surgical strategies. In addition, no well-designed trails of the ideal antimicrobial agents, administration route and

treatment duration have been conducted. As a consequence, diagnosis and treatment is both extremely challenging

and inconsistent, with highly variable and often poor outcomes. Amultidisciplinary model of care is essential and

this seminar is aimed at vascular surgeons, microbiologists and infectious diseases physicians. With reference

to the limited published evidence, approaches to diagnosis and treatment of AGI will be discussed. Towards

the development of evidence-based clinical guidelines, a proposed formal case definition will be presented,

providing a consistent diagnostic standard that is essential for clinical trial design and meaningful comparison

between various management strategies. In addition to highlighting areas for future research, a recently launched

an international, multicentre AGI service evaluation database will be introduced.