Work

Total Thoracic Aortic “Pericardialization” for Multilevel Prosthetic Graft Infection

Year: 2026

Type: article

Abstract: BACKGROUND: Prosthetic aortic infection involving composite roots and frozen elephant trunk components presents an extraordinary challenge with high mortality. We present a complex aortic reconstruction using custom bovine pericardial conduits. CASE SUMMARY: A 55-year-old man with a history of a redo Bentall procedure and frozen elephant trunk implantation presented with extensive pan-aortic prosthetic infection, systemic septic emboli, and acute intracranial hemorrhage. Surgery focused on radical debridement and complete extrication of all synthetic material. The aortic root, ascending aorta, arch, and supra-aortic branches were entirely reconstructed using 4 intraoperatively hand-fashioned bovine pericardial tube grafts, creating a classic elephant trunk assembly. The patient was extubated on the day of surgery, discharged on day 7 without neurologic deficits, and remained infection-free at 3 months. DISCUSSION: Radical excision and total aortic reconstruction using hand-made bovine pericardial grafts provide a completely biological, infection-resistant alternative for treating these highly complex conditions.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2026.110322

Authors: Miralem Pasic, Sanjay Chaubey, Kang An

Institution: Cleveland Clinic

Language: English

Topic: Infectious Aortic and Vascular Conditions

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850